系统性红斑狼疮合并周围神经病的临床特点和肌电图改变

Peripheral Neuropathies with Systemic Lupus Erythematosus:Clinical and Electrophysiological Findings

分析２２例临床有或疑有神经系统损害的系统性红斑狼疮（ＳＬＥ）患者，其中仅３例被临床诊断为ＳＬＥ合并周围神经病，然神经电生理检查证实１３例为周围神经损害。主要临床特点为对称性和非对称性四肢远端麻木、疼痛，深浅感觉障碍，肌力减退，肌萎缩等。神经电生理检查显示神经传导速度减慢，波幅降低，异常自发电位（纤颤电位和正锐波），运动单元多相电位增加。电生理检查与病理改变相符：ＳＬＥ合并周围神经病既有轴索损害，又有脱髓鞘改变。提示神经电生理检查可以为ＳＬＥ患者提供早期或亚临床周围神经损害的依据。

Twenty-two patients with systemic lupus erythematosus(SLE),who were referral to electromyographic and nerve conduction studies,were analysed. Of 22 cases,only 3 were clinically diagnosed as SLE peripheral neuropathy,whereas 13 showed involvement of peripheral nerve after the electrodiagnostic tests, The main clinical features included symmetric or asymmetric numbness,pain,weakness or amyotrophy in the distal extremities. Electrophysiological,there were sensory conduction velocity slowing,amplitude decrement of nerve action potentials, abnormal spontaneous activities and increased polyphonic motor unit potentials.Thus, the authors considered that the Electrophysiological findings were consistent with pathological observations, in which there were both atonal degeneration and segmental demyelination in the SLE peripheral neuropathy. The results showed that electrophysiological tests may provide us with early or subclinical evidence of neuropathies with SLE.