联邦止咳露依赖并发周围神经损害的研究  

Study of peripheral nerve injury attributed to anticol cough syrup abuse

作　　者：季秋虹[1] 吴二兵[1] 高志伟[1] 

机构地区：[1]南通大学附属医院神经内科,南通226001

出　　处：《南通大学学报（医学版）》2015年第2期106-108,共3页Journal of Nantong University(Medical sciences)

基　　金：国家自然科学基金资助项目(81201016;81272027;81071483)

摘　　要：目的 :探讨联邦止咳露依赖并发周围神经损害的临床表现及治疗。方法:通过患者的临床表现、肌电图、肌肉活检、腓肠神经活检结果展开临床诊断及机制分析。结果:患者长期饮用联邦止咳露致药物依赖。肌电图提示周围神经神经原性损害。肌肉活检显示肌纤维损害及少量的单核和淋巴细胞浸润。电镜下肌小节结构模糊,线粒体空泡样变。神经活检部分有髓神经纤维肿胀,板层结构松散,成剥离的洋葱皮样结构,轴索被破坏。免疫荧光染色显示轴索破坏、髓鞘变薄。结论:联邦止咳露依赖可伴发周围神经损害,在戒瘾同时予B族维生素治疗后症状缓解。Objective： To explore the clinical manifestations and treatment of peripheral nerve injury attributed to anticol cough syrup abuse. Methods： Clinical manifestations, as well as laboratory examinations, including electromyography, muscle biopsy and sural nerve biopsy were analyzed, whereby clinical diagnosis and the underlying mechanism were assessed. Results： The patients showed the drug dependence caused by long time anticol cough syrup abuse. Electromyography indicated the obvious features of peripheral neurogenic injury. Muscle biopsy revealed that the damage of muscle fibers and scattered lymphocytes and monocytes infiltration, ultrastructural changes included the cloudy structure of sarcomere and the vacuolar degeneration of mitochondria. Nerve biopsy indicated the swollen myelinated fibre loose lamellar structure and damaged axon in sural nerve. Immunofluorescent staining further confirmed the destroyed axon and thinning myelin. Conclusion： Antieol cough syrup abuse may cause peripheral nerve injury. In addition to drug treatment, the symptoms could be alleviated by Vitamin B administration.

关 键 词：周围神经损害 联邦止咳露 阿片类药物 

分 类 号：R745[医药卫生—神经病学与精神病学]