摘要
目的:对梅毒患者接触性热痛诱发电位(CHEPs)、交感神经皮肤反应(SSR)、定量感觉测定(QST)进行联合检测,评价在梅毒小神经纤维受损诊断中的价值。方法:对临床诊断为梅毒患者按照有无神经系统症状分为无神经症状组(n=24例)和有神经症状组(n=12例),分别进行CHEPs、SSR、QST检测及视觉模拟评分(VAS)并进行比较分析,同时与24名健康受试者(对照组)对照。结果:(1)SSR结果比较:有神经症状组SSR上下肢潜伏期较对照组明显延长,P<0.05;(2)QST结果比较:有神经症状组冷觉(CS)、冷痛觉(CP)阈值较对照组低;有神经症状组热觉(WS)、热痛觉(HP)阈值较对照组高;有神经症状组CS阈值较无神经症状组低;无神经症状组CP阈值较对照组低,均P<0.05;(3)CHEPs结果比较:有神经症状组右下肢潜伏期Cz/N550、Cz/P750较对照组延长,无神经症状组C7潜伏期Cz/N550较对照组延长,P<0.05;(4)VAS比较:有神经症状组及无神经症状组右下肢VAS评分较对照组高,P<0.05。结论:有神经症状梅毒及部分无神经症状梅毒患者存在小神经纤维受损,CHEPs、SSR、QST联合检测可作为判断梅毒小神经纤维受损的客观依据。
Objective： To observe the objective evidence of small nerve fibers that are damaged or not,and to evaluate the diagnostic value of neural electrophysiological detection by conducting a combination of contact heat evoked potentials（ CHEPs）,sympathetic skin responses（ SSR） and quantitative sensory test（ QST） in patients with syphilis. Methods： Comprehensive analysis of the results of CHEPs,SSR,QST and VAS in 24 healthy volunteers（ control group）,and in 36 cases of clinically diagnosed patients with syphilis that were classified as asymptomatic（ 24 cases） and neurological symptoms（ 12 cases） groups,respectively. Results：（ 1） The comparison of difference in SSR： The latency of SSR of neurological symptoms group at upper and lower limbs were obviously longer than that of the control group,with statistical significance（ P 〈0. 05）.（ 2） The comparison of difference in QST： The CS and CP of neurological symptoms group was lower than that of the control group,both with statistical significance; The WS and HP of neurological symptoms group was lower than that of the control group,with statistical significance; The CS of neurological symptoms group was lower than that of the asymptomatic group,with statistical significance; The CP of asymptomatic group was lower than that of the control group,with statistical significance（ P〈 0. 05）.（ 3） The comparison of difference in CHEPs： The latency of Cz / N550 and Cz / P750 of neurological symptoms group at right lower limb was longer than that of the control group,with statistical significance（ P 〈0. 05）. The latency of Cz /N550 in asymptomatic group at C7 was longer than that of the control group,with statistical significance（ P〈 0. 05）.（ 4） The comparison of difference in VAS at right lower limb： The VAS of neurological symptoms group and asymptomatic group were higher than that of the control group,with statistical significance（ P〈 0. 05）. Conclusion： Damage was found in small nerve fibers in some patients with syphilis. It can be used as objective basis to determine the damage in small nerve fibers by a combined detection of CHEPs,SSR and QST,and is worth further research.
出处
《川北医学院学报》
CAS
2016年第1期35-38,共4页
Journal of North Sichuan Medical College
基金
四川省教育厅自然科学一般项目(15ZB0187)
关键词
梅毒
接触性热痛诱发电位
交感神经皮肤反应
定量感觉测定
Syphilis
Contact heat evoked potentials
Sympathetic skin responses
Quantitative sensory test
