慢性轴索性多发神经病的临床特点、病因及预后  

Clinical presentation,etiology,prognosis of chronic axonal polyneuropathy

作　　者：陈亮[1] 张在强[2] 

机构地区：[1]北京市房山区第一医院神经内科,102400 [2]首都医科大学附属北京天坛医院神经内科

出　　处：《北京医学》2015年第5期419-421,共3页Beijing Medical Journal

摘　　要：目的分析慢性轴索性多发神经病的临床特点、病因构成及预后情况。方法收集2006年1月至2011年6月在天坛医院神经内科住院的81例慢性轴索性多发性神经病患者,回顾性分析其临床特点及病因诊断;以总体残疾评分总和(overall disability scale score,ODSS)评价疾病残疾程度,对部分患者进行随访。结果 81例多发性神经病患者平均年龄52岁,男∶女为49∶32。病因共10种:纯感觉性神经病34例,病因以中毒代谢为主;感觉运动性神经病46例,以免疫介导性多见(χ2=19.35 P=0.000);纯运动性1例;合并颅神经病变10例。共随访51例,预后良好40例,恶化10例,包括死亡5例。结论慢性轴索性多发性神经病病因构成复杂,本组病例最多见的是中毒代谢、免疫介导性、病因不明(chronic idiopathic axonal polyneuropathy,CIAP)。80%经病因治疗临床预后较好,但部分病因可导致严重残障甚至死亡。Objective To better understand the clinical presentation, etiology and prognosis of chronic axonal polyneuropathy. Methods Patients documented in neurology department of Beijing Tiantan Hospital with chronic axo- nal polyneuropathy were retrospectively analyzed. We also followed up part of the patients by phone call. Disability sum score was used to evaluate the severity. Results Among 81 cases in total, the etiology of 10 was identified. Thirty-four had sensory neuropathy, most of them were metabolic-toxic neuropathy. Forty-six were sensorimotor neuropathy, most of which were immune mediated neuropathy （x2=l 9.35, P = 0.000）. One was pure motor neuropathy. Fifty-one were fol- lowed up, 40 patients were improved, 10 were deteriorated, among which 5 died. Conclusion The etiology of chronic axonal polyneuropathy varies, the most frequent causes are metabolic-toxic, immune-mediated and idiopathic neuropathy. Although in some circumstance it can be disabling and fatal, based on appropriate diagnosis and treatment, over 80% case can be relieved.

关 键 词：慢性轴索性多发性神经病 临床表现 病因 预后 

分 类 号：R741[医药卫生—神经病学与精神病学]