患有小纤维神经病变症状的患者皮肤神经活检:一项回顾性研究
Sissel Løseth1,2, Maria Nebuchennykh1, Ruth Therese Brokstad1
1Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway.
Scandinavian journal of pain
|February 21, 2024
概括
小纤维神经病变 (SFN) 测试显示,不到一半的患者减少了皮内神经纤维密度 (IENFD),50%的人显示出异常的定量感官测试 (QST). 在SFN诊断标志物中没有观察到显著的性别差异.
科学领域:
- 神经学 神经学
- 临床神经生理学 临床神经生理学
- 周围神经系统疾病 周围神经系统疾病
背景情况:
- 小纤维神经病变 (SFN) 是一种影响小神经纤维的疾病,常常伴有感觉障碍.
- 在SFN中存在诊断挑战,需要对各种测试方式进行评估.
- 了解未经选择的患者队列中异常的患病率对于诊断的改进至关重要.
研究的目的:
- 评估疑似SFN患者中小纤维测试中的异常程度.
- 调查SFN诊断标记的潜在基于性别的差异.
- 为了将神经传导研究 (NCS),皮内神经纤维密度 (IENFD) 和定量感官测试 (QST) 的发现相对应.
主要方法:
- 对203名疑似SFN和正常NCS患者的回顾性分析.
- 为IENFD测量和定量感官测试 (QST) 进行皮肤活检.
- 根据年龄和性别/身高调整的Z-score被用于分析.
主要成果:
- 45.3%的患者表现出降低的IENFD,在Z分数调整后没有显著的性别差异.
- 50%的患者表现出异常的QST结果.
- 在50%的IENFD患者和50%的正常IENFD患者中观察到异常的QST.
结论:
- 不到一半的疑似SFN患者显示IENFD降低,50%的QST异常.
- 在评估的SFN标志物中没有发现显著的性别差异.
- 即使在正常IENFD中,也可能发生非髓化神经纤维的功能变化,这表明仅依靠IENFD进行SFN诊断的局限性.
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