干燥综合征伴周围神经病变的临床电生理与病理特点  

Clinical electrophysiology and pathological character of Sjogren's syndrome complicated with peripheral neuropathy

作　　者：史学菲 邱红霞 宋欣丽 杨莹 SHI Xuefei;QIU Hongxia;SONG Xinli;YANG Ying(Xi'an No.5 Hospital,Xi'an 710082,China)

机构地区：[1]西安市第五医院,陕西西安710082

出　　处：《临床医学研究与实践》2022年第2期21-23,共3页Clinical Research and Practice

基　　金：2020年度西安市第五医院院内课题(No.2020jcyb07);西安市科技计划项目[No.2019114913YX004SF037(4)]。

摘　　要：目的探究干燥综合征伴周围神经病变的临床电生理与病理特点。方法以2018年1月至2021年1月收治的50例干燥综合征伴周围神经病变患者为试验组,同时以50例干燥综合征不伴周围神经病变患者为对照组。分析试验组临床电生理以及病理特点,比较两组患者临床表现的差异性。结果试验组感觉神经传导异常患者中,10.00%为尺神经受累,20.00%为正中神经受累,70.00%为腓神经受累;运动神经传导异常患者中,63.64%为腓神经受累,36.36%为尺神经受累;12.00%为复合肌肉动作电位波幅或/和感觉电位波幅异常,6.00%为左腓肠神经感觉神经传导动作电位未引出,4.00%为左腓总神经运动传导复合肌肉动作电位波幅降低;针极肌电图显示32.00%伴有神经源性损害,24.00%为拇短展肌受损,22.00%为颈前肌受损,6.00%为股四头肌受损。58.00%存在髓鞘脱失、松解的情况;38.00%束间血管为纤维闭塞性血管炎;18.00%经皮肤活检显示存在非特异性血管周围炎;34.00%实施唇腺检查显示存在淋巴细胞浸润灶。试验组的肢体麻木、关节肿痛发生率高于对照组(P<0.05)。结论干燥综合征伴周围神经病变患者存在感觉神经、运动神经电生理异常的情况,病理学检查显示存在血管炎、髓神经纤维减少等的情况,且会出现肢体麻木、关节肿痛等症状。Objective To investigate the clinical electrophysiology and pathological character of Sjogren's syndrome complicated with peripheral neuropathy.Methods A total of 50 patients with Sjogren's syndrome complicated with peripheral neuropathy treated from January 2018 to January 2021 were selected as experimental group,and 50 patients with Sjogren's syndrome without peripheral neuropathy were selected as control group.The clinical electrophysiology and pathological character of the experimental group were analyzed,and the differences of clinical manifestations between the two groups were compared.Results Among the patients with abnormal sensory nerve conduction in the experimental group,10.00%were ulnar nerve involvement,20.00%were median nerve involvement,and 70.00%were peroneal nerve involvement;among the patients with abnormal motor nerve conduction,63.64%were peroneal nerve involvement and 36.36%were ulnar nerve involvement;12.00%had abnormal complex muscle action potential amplitude or/and sensory potential amplitude,6.00%had no sensory nerve conduction action potential of left sural nerve,4.00%had reduced complex muscle action potential amplitude of left peroneal nerve motor conduction;needle electromyography showed that 32.00%were accompanied by neurogenic damage,24.00%were abductor pollicis brevis,22.00%were anterior cervical muscle and 6.00%were quadriceps femoris muscle.Demyelination and release of myelin sheath were found in 58.00%;fibroocclusive vasculitis of interfascicular vessels were found in 38.00%;skin biopsy showed non-specific perivasculitis in 18.00%.The labial gland examination showed lymphocytic infiltration in 34.00%.The incidences of limb numbness and joint swelling and pain in the experimental group were higher than those in the control group(P<0.05).Conclusion Patients with Sjogren's syndrome complicated with peripheral neuropathy have electrophysiological abnormalities of sensory nerve and motor nerve.Pathological examination showed vasculitis and decreased myelinated nerve fibers.And there

关 键 词：干燥综合征 周围神经病变 电生理 

分 类 号：R593.2[医药卫生—内科学]