中国神经再生研究(英文版) ›› 2014, Vol. 9 ›› Issue (1): 101-110.doi: 10.4103/1673-5374.125337

• 原著:脊髓损伤修复保护与再生 • 上一篇    

危重症多发性神经病和肌病:系统性综述

  

  • 收稿日期:2013-11-25 出版日期:2014-01-05 发布日期:2014-01-05
  • 基金资助:

    中国国家留学基金(No. 2008102056),国家自然科学基金(No. 81241147).

Critical illness polyneuropathy and myopathy: a systematic review

Chunkui Zhou1, 2, Limin Wu1, 3, Fengming Ni4, Wei Ji5, Jiang Wu1, Hongliang Zhang1   

  1. 1 Department of Neurology, the First Bethune Hospital, Jilin University, Changchun 130021, Jilin Province, China
    2 Department of Neurology, the Second Part, the First Bethune Hospital, Jilin University, Changchun 130021, Jilin Province, China
    3 Neuroprotection Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
    4 Department of Radiotherapy, Oncology Center, the First Bethune Hospital, Jilin University, Changchun 130021, Jilin Province, China
    5 Department of Vascular Surgery, People’s Hospital of Jilin Province, Changchun 130000, Jilin Province, China
  • Received:2013-11-25 Online:2014-01-05 Published:2014-01-05
  • Contact: Hongliang Zhang, M.D., Ph.D., Department of Neurology, the First Bethune Hospital, Jilin University, Xinmin street 71#, Changchun 130021, Jilin Province, China, drzhl@hotmail.com, Hongliang.Zhang@ki.se.
  • Supported by:

    This work was supported by grants from China Scholarship Council, No. 2008102056; the National Natural Science Foundation of China, No. 81241147.

摘要:

重症性多发性神经病和重症性肌病是常见的可累及运动和感觉轴索的严重疾病的并发症,通常表现为呼吸肌和四肢肌肉的无力。二者单独或者联合起病,可能会增加重症监护病房的院内病死率,并且可能造成呼吸机脱机失败。急性期过后的数月至数年,很多患者仍持续性的遭受运动能力下降和生活质量受损。最近,重症性多发性神经病和重症性肌病的病理生理机制得到了更深一步的阐明。以临床表现和实验室检查结果仔细评价能够鉴别重症性多发性神经病、重症性肌病和吉兰-巴雷综合征。文章总结了重症性多发性神经病和肌病的病理生理学机制、诊断和治疗的最新知识,以及与吉兰-巴雷综合征的鉴别诊断要点。

关键词: 神经再生, 神经退行性疾病, 综述, 重症性多发性神经病, 重症性肌病, 重症监护病房, 败血症, 多器官功能衰竭, 吉兰-巴雷综合征, 国家自然科学基金

Abstract:

Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles, respectively. Clinically, they manifest as limb and respiratory muscle weakness. Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation. Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event. Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy. Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population. The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical, diagnostic, differentiating, and treatment information for this debilitating neurological disease.

Key words: nerve regeneration, neurodegenerative diseases, critical illness polyneuropathy, critical illness myopathy, intensive care unit, sepsis, multiple organ failure, Guillain-Barré, syndrome, NSFC grant, neural regeneration