Chronic inflammatory demyelinating polyradiculoneuropathy. A clinical and electrophysiological study of 92 cases.
Chronic inflammatory demyelinating polyradiculoneuropathy. A clinical and electrophysiological study of 92 cases.
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慢性炎症性脱髓鞘性多发性神经根神经病。
DOI：
10.1093/brain/110.6.1617
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发表时间：
1987
期刊：
影响因子：
--
通讯作者：
J. McLeod
中科院分区：
文献类型：
--
作者：
P. Mccombe;J. Pollard;J. McLeod
本文对92例慢性炎症性脱髓鞘性多根神经病变（CIDP）患者进行了研究，以更好地确定其临床特征、病程和预后，并确定可能的病因。87例患者行腓肠神经活检。对所有患者进行了电生理研究，结果显示运动传导明显减慢，感觉传导受损。发病通常是渐进的，但有15例（16%）患者发病迅速。男性比女性更容易受到影响。虚弱和感觉异常是最常见的症状，但疼痛往往是一个特征。发病年龄从2岁到72岁。60例患者（65%）有复发病程，32例患者（35%）有进展或单相病程；复发患者的发病年龄明显较早。32例（35%）患者有既往感染史或其他可能的既往沉淀事件，且患者血清巨细胞病毒抗体滴度明显高于对照组。这些患者的随访时间平均约为10年。大多数患者（73%）恢复良好且独立，但有7例患者因疾病死亡或完全无法活动。讨论了皮质类固醇治疗、免疫抑制剂和血浆置换治疗的价值。
Ninety-two patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) have been studied in order to define better the clinical features, course and prognosis of the condition and to identify possible aetiological factors. Sural nerve biopsy was performed on 87 subjects. Electrophysiological studies were undertaken on all patients and demonstrated marked slowing of motor conduction and impairment of sensory conduction. The onset was usually gradual but there was a rapid rate of onset in 15 (16%) patients. Males were more commonly affected than females. Weakness and paraesthesiae were the most common symptoms but pain was frequently a feature. Age of onset ranged from 2 to 72 years. Sixty patients (65%) had a relapsing course and 32 patients (35%) a progressive or monophasic course; there was a significantly earlier age of onset in patients with relapsing disease. Thirty-two patients (35%) gave a history of preceding infection or some other possible antecedent precipitating event and there was a significantly higher titre for cytomegalovirus antibodies in the serum of patients with CIDP than in controls. The patients were followed up for an average time of approximately ten years. Most patients (73%) had made a good recovery and were independent, but 7 patients had either died or were completely immobilized as a result of their disease. The value of treatment with corticosteroid therapy, immunosuppressive agents and plasma exchange is discussed.