甲钴胺治疗尿毒症性周围神经病变的疗效观察

目的：探讨甲钴胺治疗尿毒症性周围神经病变的疗效。方法：选择2012年1月~2012年12月本院100例尿毒症性周围神经病变患者。采用随机对照试验分为研究组与对照组,研究组采用甲钴胺,对照组采用维生素B12治疗,观察治疗6个月后临床症状体征变化、神经传导速度的变化及采用SF-36量表评估治疗前后尿毒症周围神经病变患者的生活质量变化,并与对照组进行比较。结果：治疗6个月后研究组＂四肢远端的麻木与烧灼感＂、＂自发性疼痛＂、＂膝腱反射消失＂、＂四肢感觉减退＂的发生率较对照组显著降低（P均〈0.05）。研究组治疗后正中神经的感觉神经传导速度（SCV）、运动神经传导速度（MCV）较对照组相比差异有统计学意义,腓总神经方面差异无统计学意义（P〉0.05）。治疗后研究组SF-36量表中＂SF-36总分＂、＂生理功能＂、＂生理职能＂、＂躯体疼痛＂差异有统计学意义,其余差异无统计学意义。结论：在维持性血液透析的尿毒症性周围神经病变患者中,甲钴胺可作为血液透析治疗基础上重要的辅助治疗药物。

Efficacy of Mecobalamin in Patients with Uremic Peripheral Neuropathy

Objective：To investigate the efficacy of mecobalamin in patients with uremic peripheral neuropathy were collect-ed. Methods：Randomized controlled trials were taken and patients were randomly divided into the study group and the control group. Mecobalamin was used in the study group and vitamin B12 treatment in control group. Clinical symptoms and changes of nerve conduc-tion velocity were observed after 6 months of treatment. The SF-36 scale was used to assess the quality of life of patients with uremic peripheral neuropathy after treatment,and it was compared with the control group. Results：After 6 months of treatment,in study group,the incidence of“distal limb numbness and burning sensation”,“spontaneous pain”,“knee jerk reflex”,“limb hypoesthe-sia”were significantly decreased than the control group（P〈0. 05）. After treatment in study group,sensory nerve conduction velocity （ SCV）,motor nerve conduction velocity（ MCV）in median nerve was statistically different with the control group. But no significant difference was found in the common peroneal nerve（P〉0. 05）. After treatment in the study group“SF-36 scores”,“physical func-tion”,“role physical”,“bodily pain”in the SF-36 scale was significantly different,but the rest was no significantly different. Conclusion：In uremic hemodialysis patients with peripheral neuropathy,mecobalamin can be used as hemodialysis treatment on the basis of important drug adjuvant therapy.