Abstract：
OBJECTIVE: The follow-up and monitoring of response to immunomodulatory therapy in patients with chronic inflammatory demyelinating polyneuropathy are still challenging. Various outcome measures have been proposed in recent years, and some are now frequently used in daily clinical practice; however, reliable biomarkers for the disease activity and treatment response are lacking.
METHODS: Cross-sectional nerve area of the bilateral vagus, fifth and the sixth cervical spinal, median, ulnar, tibial, peroneal, and sural nerves were measured at 2 time points with an interval of 6 months using nerve ultrasound. The results were used to calculate the ultrasound pattern sumscore (UPSS). The correlation between UPSS change (ΔUPSS) and changes in functional and nerve conduction studies measures over the study period were assessed.
RESULTS: Sixteen patients completed this prospective, observational study. General linear model showed that ΔUPSS is significantly associated with ΔMedical Research Council sumscore (β = -0.72, P = 0.003), Δhandgrip strength (β = -0.57, P = 0.014), ΔRasch-built overall disability scale (β = -0.57, P = 0.010), and Δoverall neuropathy limitations scale (β = 0.75, P < 0.001), after adjustment of confounding variables. Nevertheless, ΔUPSS was not correlated with other clinical measures, including Δpinch power, Δ9-hole peg test, Δ10-m walking test, and Δnerve conduction study sumscore ( P values > 0.05).
CONCLUSIONS: Nerve ultrasound might be an efficient method for monitoring the functional status of patients with chronic inflammatory demyelinating polyneuropathy over time because the alterations in its scores could significantly reflect clinical changes.
METHODS: Cross-sectional nerve area of the bilateral vagus, fifth and the sixth cervical spinal, median, ulnar, tibial, peroneal, and sural nerves were measured at 2 time points with an interval of 6 months using nerve ultrasound. The results were used to calculate the ultrasound pattern sumscore (UPSS). The correlation between UPSS change (ΔUPSS) and changes in functional and nerve conduction studies measures over the study period were assessed.
RESULTS: Sixteen patients completed this prospective, observational study. General linear model showed that ΔUPSS is significantly associated with ΔMedical Research Council sumscore (β = -0.72, P = 0.003), Δhandgrip strength (β = -0.57, P = 0.014), ΔRasch-built overall disability scale (β = -0.57, P = 0.010), and Δoverall neuropathy limitations scale (β = 0.75, P < 0.001), after adjustment of confounding variables. Nevertheless, ΔUPSS was not correlated with other clinical measures, including Δpinch power, Δ9-hole peg test, Δ10-m walking test, and Δnerve conduction study sumscore ( P values > 0.05).
CONCLUSIONS: Nerve ultrasound might be an efficient method for monitoring the functional status of patients with chronic inflammatory demyelinating polyneuropathy over time because the alterations in its scores could significantly reflect clinical changes.
摘要：
目的：慢性炎症性脱髓鞘性多发性神经病患者对免疫调节治疗反应的随访和监测仍具有挑战性。近年来提出了各种成果措施,有些现在经常在日常临床实践中使用；然而，缺乏疾病活动和治疗反应的可靠生物标志物。
方法：双侧迷走神经的横截面面积，第五和第六颈椎，中位数，尺骨,胫骨,腓骨,使用神经超声在2个时间点测量腓肠神经，间隔6个月。结果用于计算超声模式总和(UPSS)。评估了研究期间UPSS变化（ΔUPSS）与功能和神经传导研究指标变化之间的相关性。
结果：16名患者完成了这项前瞻性研究，观察性研究。一般线性模型显示，ΔUPSS与Δ医学研究理事会评分显著相关(β=-0.72，P=0.003)。Δ握力(β=-0.57,P=0.014),ΔRasch建立的总体残疾量表（β=-0.57，P=0.010），和Δ总体神经病变限制量表（β=0.75，P<0.001），在调整混杂变量后。然而，ΔUPSS与其他临床指标无关，包括Δ捏合功率，Δ9孔栓试验,Δ10-m步行试验,和Δ神经传导研究总评分(P值>0.05)。
结论：神经超声可能是监测慢性炎症性脱髓鞘性多发性神经病患者随时间变化的功能状态的有效方法，因为其评分的变化可以显着反映临床变化。
方法：双侧迷走神经的横截面面积，第五和第六颈椎，中位数，尺骨,胫骨,腓骨,使用神经超声在2个时间点测量腓肠神经，间隔6个月。结果用于计算超声模式总和(UPSS)。评估了研究期间UPSS变化（ΔUPSS）与功能和神经传导研究指标变化之间的相关性。
结果：16名患者完成了这项前瞻性研究，观察性研究。一般线性模型显示，ΔUPSS与Δ医学研究理事会评分显著相关(β=-0.72，P=0.003)。Δ握力(β=-0.57,P=0.014),ΔRasch建立的总体残疾量表（β=-0.57，P=0.010），和Δ总体神经病变限制量表（β=0.75，P<0.001），在调整混杂变量后。然而，ΔUPSS与其他临床指标无关，包括Δ捏合功率，Δ9孔栓试验,Δ10-m步行试验,和Δ神经传导研究总评分(P值>0.05)。
结论：神经超声可能是监测慢性炎症性脱髓鞘性多发性神经病患者随时间变化的功能状态的有效方法，因为其评分的变化可以显着反映临床变化。
