《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (05): 400-401.

• 临床观察 • 上一篇    下一篇

丙烯酰胺中毒对周围神经和血管的损害

王朝霞; 张锦丽; 石昕; 孙相如; 袁云   

  1. 1.北京大学第一医院神经内科 北京市 100034;2.北京263医院神经内科 北京市 101149
  • 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

WANG Zhao-xia, ZHANG Jin-li,SHI Xin, et al   

  1. Department of Neurology, the 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： 目的探讨急性丙烯酰胺中毒患者的周围神经和血管的病理改变。方法报道2 例青年男性工作中接触丙烯酰胺的患者。结果2例患者的神经传导速度和诱发电位均明显异常。神经活检显示有髓神经纤维轻度减少,在例1可以看到有髓神经纤维和无髓神经纤维的轴索变性和出现个别巨大轴索。例2的有髓神经纤维和无髓神经纤维的轴索出现Wallerian变性和轴索内微丝聚集现象。两例患者均存在个别有髓神经纤维的髓鞘变薄。小动脉内膜显著肥厚,毛细血管周细胞存在凋亡改变,毛细血管的基底膜显著肥厚。结论丙烯酰胺中毒的周围神经损害为轴索性周围神经病伴随有髓神经纤维的髓鞘损害。血管损害在周围神经病变的发生中也可能发挥重要作用。

关键词: 丙烯酰胺, 神经毒性, 周围神经病, 血管病, 病理

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