炎症性脱髓鞘性多发性神经病急性期临床评价  

Clinical evaluation of acute phase of inflammatory demyelinating polyneuropathy

作　　者：林秋红[1] 蔡伦[1] 周艳英[1] LIN Qiuhong;CAI Lun;ZHOU Yanying(The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西中医药大学第一附属医院,广西南宁530023

出　　处：《中国实用神经疾病杂志》2020年第14期1217-1220,共4页Chinese Journal of Practical Nervous Diseases

基　　金：广西自然科学基金项目(编号:2015GXNSFBA139172);广西中医药大学第一附属医院学术团队建设项目(编号:院字[2018]146号);广西中医药大学“岐黄工程”高层次人才团队培育项目(编号:2018003);卫生人才队伍建设广西医学高层次骨干人才培养“139”计划。

摘　　要：目的比较急性炎症性脱髓鞘性多发性神经病(AIDP)与慢性炎症性脱髓鞘性多发性神经病急性起病(A-CIDP)成年患者的临床和电生理特点。方法收集AIDP或A-CIDP患者44例(AIDP,n=30;A-CIDP,n=14)。分析人口学特征、临床表现、脑脊液特点、电生理检测特点。结果 AIDP与A-CIDP患者多见于男性(53%vs 72%,P=0.33),AIDP具有糖尿病病史患者比例相对较低(3%vs 28%,P=0.03),脑神经功能障碍较多见(56%vs 14%,P=0.01),从发病进展到病情最高峰的时间较短(8.2d vs 18.2d,P=0.04);MRC总分均值较低(40 vs 50,P=0.01),mNCV减慢的百分比较低(33%vs 71%,P=0.04)。结论发病进展到病情最严重时间为8 d左右,表现有脑神经功能障碍,MRC总分较低,mNCV减慢比例较低且有轴索损伤,应考虑诊断AIDP,反之则考虑A-CIDP。Objective To compare the clinical and electrophysiological characteristics of AIDP and A-CIDP adult patients.Methods 44 patients with AIDP or A-CIDP were collected(AIDP,n=30;A-CIDP,n=14).Analysis of demographic characteristics,clinical manifestations,cerebrospinal fluid characteristics,electrophysiological detection characteristics.Results Compared with AIDP and A-CIDP patients,they were more common in men(53% vs 72%,P=0.33).Compared with the two,AIDP had a relatively low proportion of patients with a history of diabetes(3% vs 28%,P=0.03).Cerebral neurological dysfunction is more common(56% vs 14%,P=0.01),and the time from the onset of disease to the peak of the disease is shorter(8.2 d vs 18.2 d,P=0.04);the mean value of MRC total score is lower(40 vs 50,P=0.01),the rate of mNCV slowdown was low(33% vs 71%,P=0.04).In addition,the AIDP group was severely ill,unable to walk independently,and required mechanical ventilation(7% vs 0%,P=1.0).Conclusion The time from the onset of the disease to the most serious condition is about 8 days.It is manifested as cerebral nerve dysfunction,the total score of MRC is low,the rate of mNCV slowdown is low,and there is axonal injury(neural nerve potential).Diagnosis,otherwise consider A-CIDP.

关 键 词：急性炎症性脱髓鞘性多发性神经病 慢性炎症性脱髓鞘性多发性神经病 神经功能障碍 糖尿病 电生理检测 

分 类 号：R744.5[医药卫生—神经病学与精神病学]