慢性酒精中毒患者定量感觉特点及影响因素

Evaluation of quantitative sensory testing threshold and the affecting factors in chronic alcoholism patients

目的研究慢性酒精中毒患者的定量感觉特点,探讨定量感觉检查(QST)是否可作为早期提示神经损伤的指标,并对引起周围神经损伤的相关因素进行研究。方法选择2000年12月至2003年12月重庆医科大学附属第一医院神经内科收治的慢性酒精中毒患者(每天饮酒250mL以上,饮酒时间>5年且简易智能量表评分>27分)40例,分别测定左侧小鱼际区、食指、足背外侧、第1足趾皮区的温度觉及食指、第1足趾的振动觉阈值和胫、正中、尺神经传导速度。分析饮酒时间、全身营养状况、肝肾功能等对周围神经的影响。结果长期饮酒患者5种感觉阈值均较正常组增高(P<0·05)。有感觉异常组高于无感觉异常组(P<0·05)。QST检出的异常率较神经传导速度高。饮酒时间越长、全身营养状况越差越容易出现周围神经损害。结论QST可作为早期提示慢性酒精中毒性周围神经损害的指标。周围神经损伤与饮酒时间呈正相关,与营养状态成负相关。

Objective The aim of the present study is to evaluate the possibility of the QST characteristics of chronic alcoholism patients, and their QST results can be used as the index of early nerve damage. Analyze the contributing factors and the possible mechanism of the phenomena. Methods Thirty healthy adults and 40 patients with chronic alcoholism were evaluated, the thermal sensation threshold and vibration threshold of left hypothenar,index finger,instep and first toe was tested by TSA- Ⅱ Thermal Sensory Analyzer, and the sense and motion conduction velocity of left nervus tibialis, median nerve and nervus ulnaris were tested as well. The effects of alcohol abuse history, nutritional status, as well as biochemical parameters on neuropathy were analyzed. Results The threshold of thermal sensation of patients with chronic alcoholism disease was higher than normal person. The group of abnormal sensation had higher sensation threshold than normal. The abnormality of QST results was higher than the sense and motion conduction velocity testing. The damage of peripheral nerve was positively correlated to tippling history and nutrition status. Conclusion QST can be used as an important index for early peripheral nerve damage of chronic alcoholism.