肾功能不全时运动神经传导速度的观察

Observation of motor nerve conduction velocity in renal insufficiency

肾功能不全时周围神经病变早期表现为感觉和运动神经传导速度减慢,国外已经重视国内尚未见报告。我们自1982年2月至1984年4月对46例具有不同程度肾功能损害的肾脏病人和29例健康人作了运动神经传导速度(MCV)、末端潜伏期、Hoffman反射(H反射)的测定,并对6例腹膜透析患者进行了透析前后MCV动态观察,以探讨以上因素与肾功能的关系。对象和方法 46名肾脏病患者中男30名,女16名,年龄20～65岁。病因诊断:慢性肾炎35例,慢性肾盂肾炎5例,原发性肾病3例,多囊肾2例,急性肾衰1例。正常对照组29名均经体检证实身体健康。

46 patients with primary renal insufficiency of varying severity and 29 normal control subjects were investigated for a determination of the motor nerve conduction velocities (MCV) of the medien, ulnar, common peroneal and tibial nerves and of the distal latencies of those-nerves and latencies of H reflex. According to clearance of creatinine, the patients were divided into 3 groups:(1) Ccr 84.4±21.6ml/min,(2) Ccr 24.31±8.9ml/min,(3) Ccr 6.06±3.78ml/min.The studies of MCV showed significant difference between group 3 and groups 1,2,and normal control (P<0.01). There was consistent correlation between the severity of renal insufficiency and the abnormality of MCV.The differences of the latency of H reflex among four groups were significantly different (P<0.01).Six patients on CAPD had their MCV measured prior to dialysis and during the first 2 months of dialysis.The values of MCV increased significantly after dialysis. We found that MCV and H reflex latency are sensitive indicators of the onset of uremic neuropathy.