慢性炎症性脱髓鞘性多发性神经根神经病的轴索损害

Nerve Axonal Damage in Chronic Inflammatory Demyelinating Polyneuropathy

目的分析慢性炎症性脱髓鞘性多神经病(CIDP)的临床、脑脊液、病理学和电生理特点,研究CIDP的轴索损害。方法对2005年1月至2011年12月由河北省几所医院收集整理并确诊治疗的32例CIDP患者入院后的常规检查、脑脊液检查、病理学检查及电生理检查结果进行分析。结果从病理学上分类,轻微改变类型4例,脱髓鞘为主类型8例,轴索损害为主类型15例,混合损害类型(有髓神经纤维的髓鞘和轴索混合损害)5例,各组脑脊液蛋白比较差异无统计学意义(P=0.765)。在电生理改变上,脱髓鞘为主类型者和轴索损害为主类型者均有不同程度的脱髓鞘和轴索损害。结论 CIDP的轴索损害是普遍存在现象,临床上应引起重视。

Objective To analyze the clinical,cerebrospinal fluid,pathology and electrophysiological characteristics of chronic inflammatory demyelinating polyneuropathy（CIDP）,and study CIDP axonal damage.Methods Analysis on the findings of routine examination,cerebrospinal fluid examination,pathological examination and electrophysiological examination of 32 cases of CIDP patients admitted to several hospitals in Hebei province from January 2005 to December 2011 collected was done.Results From the pathological classification,slight change type was observed in 4 patients,demyelinating as the main type was observed in 8 patients,axonal damage as the main type was observed in 15 cases,mixed type of damage（myelinated nerve fiber myelin and axonal damage） was observed in 5 patients;cerebrospinal fluid protein of each group had no significant difference（P = 0.765）.In the electrophysiological changes,demyelination as main type and axonal damage as main type both had different degrees of demyelination and axonal damage.Conclusion CIDP axonal damage is a common clinical phenomenon,which should cause due attention.