原发性干燥综合征患者周围神经病变临床分析  

An investigation on peripheral neuropathy in patients with primary Sj（o）gren＆#39;s syndrome

作　　者：陈梅卿[1] 李燕[1] 刘晓燕[2] 陈子卿[3] 林庆衍[1] 孙华瑜[1] 孙月池[1] 石桂秀[1] 

机构地区：[1]厦门大学附属第一医院风湿免疫科, 361000 [2]厦门大学附属第一医院神经内科, 361000 [3] 福建省惠安县医院内科

出　　处：《中华风湿病学杂志》2014年第7期455-459,共5页Chinese Journal of Rheumatology

摘　　要：目的 了解pSS合并周围神经病变的患病率及其临床、实验室特点.方法 入选符合2002年国际分类标准的pSS患者52例,选择同期我院体检中心健康体检者25名为健康对照组,所有的研究对象均行四肢神经传导（NCV）检查,了解pSS相关周围神经病变的患病率,并对pSS患者的临床及实验室特点进行分析.数据分析采用t检验、x2检验、Fisher确切概率法.结果 pSS患者中NCV异常检出率79％（41/52）,而健康对照组仅12％（3/25）,2组间差异有统计学意义（x2=30.8,P＜0.01）.pSS患者的周围神经病变症状多样,其中无症状患者达37％（15/41）.受累神经按频次依次见于正中神经（30例）、尺神经（24例）、胫神经（18例）、腓总神经（12例）、腓浅神经（10例）;神经病变类型以单纯感觉神经病变最常见（20例）,其次为感觉运动神经混合病变（14例）;感觉神经以髓鞘病变为主（31例）,而运动神经则以轴突病变多见（18例）.NCV异常与NCV正常的pSS患者的发病年龄、病程、欧洲抗风湿联盟SS疾病活动度评分（ESSDAI）及临床与实验室特征（除感觉异常、运动障碍外）差异均无统计学意义（P＞0.05）.结论 pSS合并周围神经病变常见,且临床表现和电生理特征呈多样性;对pSS患者常规进行电生理检测,不失为提高周围神经病变检出率的有效方法.Objective To investigate the prevalence of peripheral neuropathy （PN） associated with primary Sj（o）gren＆#39;s syndrome （pSS）,and to describe the clinical and laboratory features of pSS patients with PN.Methods Fifty-two patients who fulfilled the 2002 American-European Consensus Group criteria for pSS were enrolled into the study.Twenty-five healthy persons from Physical Examination Center of our hospital during the same period served as the normal control group.All subjects underwent limb nerve conduction velocity （NCV） examination to investigate the prevalence of pSS related PN.And the clinical and laboratory features of pSS were collected and analyzed.Data were analyzed by t test,x2 test,Fisher exact probability test.Results The NCV abnormal rate was 79％（41/52） in pSS patients,while the control group was only 12％（3/25）,there was significant difference between the two groups （x2=30.8,P＜0.01）.The clinical spectrum of peripheral neuropathies encountered in pSS was wide,including asymptomatic patients which up to 37％（15/41）.The involved nerve according to frequencies were found in the median nerve （30 cases）,ulnar nerve （24 cases）,tibial nerve （18 cases）,common peroneal nerve （12 cases） and superficial peroneal nerve （10 cases）.The type of neuropathy with pure sensitive abnormality was the most common,followed by mixed sensory and motor nerve lesions.Myelin lesions were most likely involved in sensory neuropathies,while axon lesions were in motor neuropathies.The age of onset,course of disease,disease activity index of ESSDAI and the clinical and laboratory features （except paresthesia/movement barrier） showed no significant difference （P＞0.05） between the two groups of pSS patients with NCV abnomality and NCV normal.Conclusion Peripheral neuropathy is not a rare manifestation of pSS,and it＆#39;s clinical and electrophysiological spectrum is wide.Routinely carrying out electrophysiological examination on pSS patients is an effective method t

关 键 词：干燥综合征 周围神经系统疾病 神经电生理表现 临床与实验室特征 

分 类 号：R593.2[医药卫生—内科学]