四例化学物中毒性周围神经病患者病理特点及神经电生理分析

Pathology and neurophysiology analysis for peripheral neuropathy of four patients with chemicals poisoning

目的通过对4例化学物中毒性周围神经病变的病理特点分析，诠释慢性正己烷、砷中毒时的神经电生理结果。方法回顾4例化学物中毒性周围神经病患者，分析其神经电生理及周围神经病理特点。结果4例患者中2例为慢性轻度正已烷中毒，神经电生理检查提示髓鞘脱失和轴索损害均存在，腓浅神经活检病理示以髓鞘损害为主的周围神经病变；另2例为亚急性砷中毒患者，神经电生理检查提示轴索损害伴髓鞘脱失，病理活检示轻度周围神经损害，以轴索为主。结论化学物中毒性周围神经病的病理改变随着病程进展可同时存在轴索病变和脱髓鞘改变。

Objective To study the nerve electromyogram results by analysing the pathological characters of 4 cases diagnosed as peripheral neuropathy caused by n-hexane and arsenic. Methods The nerve electromyogram examination and pathology data of 4 patients, who had been diagnosed as toxic chemicals peripheral neuropathy, were studied retrospectively. Results Two patients in this group were exposed to n- hexane, their nerve electromyogram examinations and biopsy pathology of superficial peroneal nerve indicated the peripheral neuropathy was mainly manifests the lesion of medullary sheath. Another two patients were exposed to arsenic, their nerve electromyogram examinations showed axonal degeneration associated with demyelination, and their biopsy pathology showed the peripheral neuropathy was mainly axonal degeneration. Conclusion Axonal degeneration and demyelination always coexist in peripheral neuropathy caused by chemicals.