目的:探索慢性腰痛病人利兹神经病理性症状和体征疼痛评分(leeds assessment of neuropathic symptoms and sign,LANSS)与疼痛强度的关系。方法:(1)三家研究中心(北京大学人民医院、中日友好医院和南京军区南京总医院)入选的慢性腰痛病...目的:探索慢性腰痛病人利兹神经病理性症状和体征疼痛评分(leeds assessment of neuropathic symptoms and sign,LANSS)与疼痛强度的关系。方法:(1)三家研究中心(北京大学人民医院、中日友好医院和南京军区南京总医院)入选的慢性腰痛病人填写LANSS量表及疼痛数字评分量表(numerical rating scale,NRS)。(2)使用spearman相关分析评价LANSS量表评分与疼痛强度的关系。结果:入组2115例慢性腰痛病人,总合格率为90.0%,调查对象平均年龄为50.1±15.6年,合格病人中男778例,女1125例。LANSS评分中值随疼痛强度的增加有一定的增长,但是两者的spearman秩相关系数小于0.4,且LANSS量表各项评分与疼痛强度的spearman秩相关系数均小于0.4。结论:中文版LANSS评分随疼痛强度的增加有一定的上升趋势,但是两者并无相关性。展开更多
The underlying cause of diabetic neuropathy remains unclear,although pathological studies have suggested an ischaemic basis related to microangiopathy, possibly mediated through effects on the energy-dependent Na+/K+p...The underlying cause of diabetic neuropathy remains unclear,although pathological studies have suggested an ischaemic basis related to microangiopathy, possibly mediated through effects on the energy-dependent Na+/K+pump. To investigat e the pathophysiology of diabetic neuropathy, axonal excitability techniques wer e undertaken in 20 diabetic patients with neuropathy severity graded through a c ombination of quantitative sensory testing (QST) using a vibratory stimulus, ass essment of symptom severity using the Total Neuropathy Symptom Score (T-NSS) an d measurement of glycosylated haemoglobin as a marker of disease control. To ass ess axonal excitability,compound muscle action potentials were recorded at rest from abductor pollicis brevis following stimulation of the median nerve, and sti mulus-response behaviour, threshold electrotonus,a current-threshold relationship and the recovery of excitability were recorded in each patient. All patients had established neuropathy,with abnormalities of T-NSS present in all patients and QST abnormalities present in 65%. Compared w ith controls,diabetic neuropathy patients had significant reduction in maximal C MAP amplitude (P < 0.0005), accompanied by a‘fanning in’of threshold electroto nus. In addition, the strength-duration time constant was decreased in diabetic neuropathy patients and recovery cycles were altered with reductions in refract oriness,the duration of the relative refractory period, superexcitability and su bexcitability. It is proposed that while the changes in threshold electrotonus w ith supportive findings in the currentthreshold relationship are consistent with axonal depolarization,possibly mediated by a decrease in Na +/K+pump activity , the alterations in the recovery cycle of excitability could be explained on th e basis of a smaller action potential, reflecting a limitation on the nodal driv ing current imposed by a reduction in Na+conductances.展开更多
文摘目的:探索慢性腰痛病人利兹神经病理性症状和体征疼痛评分(leeds assessment of neuropathic symptoms and sign,LANSS)与疼痛强度的关系。方法:(1)三家研究中心(北京大学人民医院、中日友好医院和南京军区南京总医院)入选的慢性腰痛病人填写LANSS量表及疼痛数字评分量表(numerical rating scale,NRS)。(2)使用spearman相关分析评价LANSS量表评分与疼痛强度的关系。结果:入组2115例慢性腰痛病人,总合格率为90.0%,调查对象平均年龄为50.1±15.6年,合格病人中男778例,女1125例。LANSS评分中值随疼痛强度的增加有一定的增长,但是两者的spearman秩相关系数小于0.4,且LANSS量表各项评分与疼痛强度的spearman秩相关系数均小于0.4。结论:中文版LANSS评分随疼痛强度的增加有一定的上升趋势,但是两者并无相关性。
文摘The underlying cause of diabetic neuropathy remains unclear,although pathological studies have suggested an ischaemic basis related to microangiopathy, possibly mediated through effects on the energy-dependent Na+/K+pump. To investigat e the pathophysiology of diabetic neuropathy, axonal excitability techniques wer e undertaken in 20 diabetic patients with neuropathy severity graded through a c ombination of quantitative sensory testing (QST) using a vibratory stimulus, ass essment of symptom severity using the Total Neuropathy Symptom Score (T-NSS) an d measurement of glycosylated haemoglobin as a marker of disease control. To ass ess axonal excitability,compound muscle action potentials were recorded at rest from abductor pollicis brevis following stimulation of the median nerve, and sti mulus-response behaviour, threshold electrotonus,a current-threshold relationship and the recovery of excitability were recorded in each patient. All patients had established neuropathy,with abnormalities of T-NSS present in all patients and QST abnormalities present in 65%. Compared w ith controls,diabetic neuropathy patients had significant reduction in maximal C MAP amplitude (P < 0.0005), accompanied by a‘fanning in’of threshold electroto nus. In addition, the strength-duration time constant was decreased in diabetic neuropathy patients and recovery cycles were altered with reductions in refract oriness,the duration of the relative refractory period, superexcitability and su bexcitability. It is proposed that while the changes in threshold electrotonus w ith supportive findings in the currentthreshold relationship are consistent with axonal depolarization,possibly mediated by a decrease in Na +/K+pump activity , the alterations in the recovery cycle of excitability could be explained on th e basis of a smaller action potential, reflecting a limitation on the nodal driv ing current imposed by a reduction in Na+conductances.
