评估肝硬化患者的定量和选择性感觉纤维功能障碍

Nan-Nan Zhang, Zhi-Yong Wang, Jian-Min Chen, Zhi-Peng Yan, Guo-Xin Ni, Jun Ni
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摘要

背景:据报道,慢性肝病与周围神经病变有关。然而,哪些感觉纤维会受到影响仍是未知数。本研究的目的是使用电流感知阈值(CPT)测试法检测肝硬化患者感觉神经纤维的功能,以及与肝硬化相关的血液生化指标与 CPT 值之间的相关性:我们招募了 44 名肝硬化患者和 37 名同年龄、同性别的健康对照者。使用用于 CPT 测试的 Neurometer® 系统,以三种不同的参数(2000 Hz、250 Hz 和 5 Hz)刺激右手食指的正中神经以及右手拇指的腓深神经和腓浅神经。对感觉神经的 CPT 值进行了比较分析。此外,研究人员还分析了 CPT 值与血液生化指标之间的相关性:结果:在 2000 Hz 电刺激下,肝硬化组和健康对照组的正中神经、腓深神经和腓浅神经均存在显著差异(P < 0.05)。此外,在电刺激频率为 250 Hz 时,肝硬化组的正中神经 CPT 值明显高于对照组(p = 0.005)。CPT值与血液生化指标之间没有相关性:结果显示,肝硬化患者的感觉性周围神经病变主要表现为 Aβ 纤维神经病变。
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Evaluation of Quantitative and Selective Sensory Fiber Dysfunction in Patients with Cirrhosis.

Background: Chronic liver disease has been reported to be associated with peripheral neuropathy. However, which sensory fibers are affected remains unknown. The objective of this study was to examine the function of sensory nerve fibers in patients with cirrhosis using the current perception threshold (CPT) test, as well as the correlation between blood biochemical indicators related to cirrhosis and CPT values.

Methods: We recruited 44 patients with liver cirrhosis and 37 healthy controls of the same age and gender. The Neurometer® system for the CPT test was used to stimulate the median nerve on the right index finger, as well as the deep and superficial peroneal nerves on the right hallux, using three distinct parameters (2000 Hz, 250 Hz, and 5 Hz). Comparative analysis was performed on the CPT values of the sensory nerves. Additionally, the correlation between CPT values and biochemical blood indicators in the study participants was analyzed.

Results: Under 2000 Hz electrical stimulation, there was a significant difference between the cirrhosis and healthy control groups in the median nerve as well as the deep and superficial peroneal nerves (p < 0.05). In addition, the median nerve CPT value of the cirrhosis group was significantly higher than that of the control group at an electrical stimulation frequency of 250 Hz (p = 0.005). There was no correlation between CPT values and blood biochemical indicators.

Conclusion: According to the results, the sensory peripheral neuropathy in liver cirrhosis is mainly manifested as Aβ fiber neuropathy.

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