INTRODUCTION:Neurological complications secondary to the uremic state, contribute largely to the morbidity and mortality in patients with renal failure. The prevalence of peripheral neuropathy remains high in advanced renal dysfunction. MATERIALS AND METHODS:The present cross-sectional study was conducted on 100 adult patients of chronic kidney disease between 18 and 75 years of age with serum creatinine greater than 2 mg/dL. Apart from routine examination and baseline investigations, detailed history was elicited pertaining to patients' neurological symptoms, and scored according to the Neurological Symptom Score. Motor nerve conduction velocity was measured from right median, ulnar, peroneal, and tibial nerves. RESULTS:It was observed that neurological symptoms increased steadily with raise in serum creatinine. The mean nerve conduction velocities (NCVs) of right median nerve, ulnar nerve, peroneal nerve, and tibial nerve were 51.34 ± 6.07, 53.04 ± 5.91, 44.72 ± 6.14, and 44.20 ± 5.17, respectively. The NCVs of all the tested nerves decreased significantly with increase in serum creatinine levels (p < 0.01): 70% of the patients had uremic polyneuropathy; 6% had asymptomatic neuropathy, 51% had symptomatic non-disabling neuropathy, while disabling neuropathy was seen in 13% of the patients. CONCLUSION:Our data suggests that NCV testing when complimented with meticulous neurological assessment can provide invaluable input. These tests apart from helping us detect neuropathy in advanced renal dysfunction; can also detect the disease in largely asymptomatic patients which avoids the necessity to order for detailed neurophysiological investigation.

译文

简介:继发于尿毒症状态的神经系统并发症在很大程度上影响了肾衰竭患者的发病率和死亡率。在晚期肾功能不全中,周围神经病变的患病率仍然很高。
材料与方法:本横断面研究是针对100名年龄在18至75岁之间,血清肌酐大于2mg / dL的慢性肾脏病成年患者进行的。除了常规检查和基线检查外,还可以得出有关患者神经系统症状的详细病史,并根据神经系统症状评分进行评分。从右正中,尺骨,腓骨和胫神经测量运动神经传导速度。
结果:观察到神经症状随着血清肌酐水平的升高而稳定增加。右正中神经,尺神经,腓神经和胫神经的平均神经传导速度(NCVs)分别为51.34±6.07、53.04±5.91、44.72±6.14和44.20±5.17。随着血清肌酐水平的升高,所有受测神经的NCV均显着下降(p <0.01):70%的患者患有尿毒症性多发性神经病。 6%有无症状神经病,51%有症状非致残性神经病,而13%的患者可见致残性神经病。
结论:我们的数据表明,NCV测试与细致的神经系统评估相辅相成,可以提供宝贵的信息。这些测试除了可以帮助我们检测晚期肾功能不全的神经病变以外,还可以帮助我们更好地检测神经病变。也可以在很大程度上无症状的患者中发现这种疾病,从而避免了进行详细的神经生理学检查的必要性。

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