重金属中毒所致周围神经损害的电生理研究

Electrophysiological Study on Peripheral Nerve Impairment Caused by Heavy Metal Intoxication

目的 :探讨处于重金属环境中的作业工人急、慢性中毒性周围神经损害的电生理改变。方法 :应用常规肌电图技术对 30例重金属接触者进行肌电图 (EMG)、神经传导速度 (NCV)检测。结果 :30例患者的电生理检查均呈周围神经损害 ,其中急性起病 18例 ,以轴索损害为主 ;慢性蓄积性中毒 12例 ,以脱髓鞘损害为主 ;电生理改变下肢较上肢明显 ,感觉神经传导异常重于运动神经传导。结论 :电生理学检查对研究重金属中毒所致的周围神经损害提供了重要的客观依据 ,可作为临床诊断、鉴别诊断以及了解病损程度的动态随访指标。

Objective:To investigate electrophysiological changes of acute and chronic toxic peripheral nerve impairment of those workers exposed to heavy mental environment. Results:Routine electromyography (EMG) technique was used to measure the nerve conduction velocity (NCV) and EMG examination in 30 patients exposed to heavy mental. Results:All electrophysilolgical examinations of 30 patients showed peripheral nerve impairment. Among them, 18 presented acute onset with axon impairment dominantly, and the remaining 12 patients chronic accumulated intoxication with demyelinating change; EMG changes of peripheral nerves of lower extremities were more significant than those of upper extremities; Impairment of sense nerves was more severe than motor nerves. Conclusion:EMG may suggest important evidence for peripheral neuropathy caused by heavy metal intoxication, and may be used as a dynamic parameter for diagnosis, differential diagnosis and degree of impairment.