交感神经皮肤反应和R-R间期变化率对诊断格林巴利综合征自主神经损害的意义  

Application of sympathetic skin response and R-R interval variation in Guillain-Barre syndrome

作　　者：孙瑶[1] 谢炳玓[1] 姚源蓉[1] 

机构地区：[1]天津医科大学总医院,天津300052

出　　处：《山东医药》2011年第9期4-6,共3页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(30800356);天津市自然科学基金资助项目(07JCYBJC16200);教育部留学回国人员科研启动基金(教外司留[2008]890号);天津医科大学总医院引进人才科研启动基金

摘　　要：目的应用交感神经皮肤反应(SSR)技术和R-R间期变化率(RRIV)检测分析格林巴利综合征(GBS)患者的自主神经功能变化的特点,探讨SSR和RRIV对GBS自主神经损害的诊断价值。方法选取GBS患者26例(GBS组)和健康人30例(对照组),利用丹麦产Keypoint肌电诱发电位仪记录双手和双足的SSR潜伏期和波幅,记录平静呼吸和深呼吸时的RRIV。结果①GBS组和对照组SSR的潜伏期比较无统计学差异(P>0.05),波幅比较有统计学差率(P<0.05)。②GBS组和对照组的RRIV比较,平静呼吸和深呼吸均有统计学差异(P均<0.05)。③GBS组SSR异常率与RRIV异常率比较无统计学差异(P>0.05)。GBS患者自主神经症状出现率分别与SSR、RRIV异常率比较,均有统计学差异(P均<0.05)。④轴索型GBS与髓鞘型GBS进行SSR及RRIV比较均无统计学差异(P均>0.05)。结论 SSR和RRIV可作为评价GBS自主神经损害的客观电生理指标,能发现尚无临床症状的自主神经损害。Objective To evaluate possible autonomic nervous system （ANS） dysfunction in Guillain-Barre syndrome patients by the sympathetic skin response （SSR） and the heart rate （R-R） interval variation （RRIV） measurements and discuss the value in diagnosis by SSR and RRIV in GBS. Methods We studied 26 cases of Guillain-Barre syndrome patients and 30 cases of age-matched healthy subjects, recorded the SSR latency and amplitude of hands and feet, also recorded the RRIV when people at normal breathing and deep breathing. Results ①Between the GBS group and the control group, the SSR latency was no significant difference （ P 〉 0.05 ）, the amplitude of the difference was statistically significant （ P 〈 0.05 ）. ②Compared the GBS group to the control group, RRIV at normal breathing and deep breathing were statistically significant （ P 〈 0. 05 ）. ③RRIV abnormal rate and SSR abnormal rate in GBS group were no statistical significance （ P 〉 0.05 ）. Compared with symptomatic GBS, SSR and RRIV were statistically significantly （ P 〈 0. 05 ）. ④Compared the AIDP to the AMASN, SSR and RRIV were no statistically significant （ P 〉 0.05）. Conclusions SSR and RRIV can be used as the objective electrophysiological indicators, and can find the under clinical autonomic neuropathy in GBS.

关 键 词：交感神经皮肤反应 R-R间期变化率 格林巴利综合征 自主神经通路 

分 类 号：R744.5[医药卫生—神经病学与精神病学]