《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (05): 398-399.

• 临床观察 • 上一篇    下一篇

以轴索损害为主的围产期多发性周围神经病

高云鹰; 洪丽; 毕鸿雁; 袁云   

  1. 北京大学第一医院神经内科 在职硕士 100034
  • 收稿日期:2005-01-13 出版日期:2005-05-25 发布日期:2005-05-25

Peripheral neuropathy and vasculopathy due to toxicity of acrylamide

GAO Yun-ying, HONG Li,BI Hong-yan,at al   

  1. Department of Neurology, First Hospital of Peking University ,Beijing 100034,China
  • Received:2005-01-13 Published:2005-05-25 Online:2005-05-25

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摘要： 目的分析围产期轴索性多发性周围神经病的临床和病理改变特点及可能的发病因素。方法报道1 例围产期女性患者。结果妊娠末期亚急性发病,主要表现为远端肌无力,伴随轻度的感觉减退和疼痛。症状进行性加重,分娩后7 天病情迅速恶化,伴随声音嘶哑、饮水呛咳和呼吸困难。四肢肌力减退,肌张力低,腱反射消失。辅助检查发现贫血,脑脊液蛋白升高,细胞数正常。腓肠神经活检可见神经束内有髓神经纤维显著减少,伴Wallerian变性和轴索再生现象,无脱髓鞘改变。结论存在围产期多发性轴索性周围神经病。免疫功能异常、贫血及营养障碍可能在疾病发生中具有一定的作用。

关键词: 围产期, 轴索性周围神经病

Abstract: ObjectiveTo investigate the clinical feature peripheral neuropathy and vasculopathy after acrylamide toxication. Methods2 young male patients with peripheral neuropathy who had exposed to acrylamide for job more than one year were reported.ResultsNeuroelectrophysiological examination showed marked abnormalities in both peripheral and central nerve conduction in both patients. Sural nerve biopsies revealed axonal degeneration, Wallerian degeneration and giant axon with accumulated neurofilaments. Additonally, vasculopathies including prominant thickness of arterial intesma and basal membrane of capillary as well as apoptosis of vascular pericyte, were evident. ConclusionAxonal degeneration and vascular involvement has been found in acrylamide toxication. Vascular impairment maybe plays an important role in the pathogenesis of neuropathy.

Key words: acrylamide, neurotoxicity, polyneuropathy, vasculopathy, pathology