目的:探讨与对照组相比,非质子性神经病变的神经丝轻链(NfL)水平,并确定这些变化是否与超声神经检查结果相关。
方法:招募具有提示周围神经受累的体征或症状的麻风病患者。他们通过临床检查进行了评估,功能分数,实验室评估(包括NFL),神经传导研究(NCS),和超声波。在双侧中位数进行超声检查,尺骨,胫骨,腓骨,sural,迷走神经以及颈根5和6.结果与年龄相比,性别,和体重指数匹配健康对照。
结果:共评估了20例患者的320条神经和30例对照的480条神经。与对照组的3.421.18相比,麻风病人的NfL显着升高,平均值和标准偏差为7.502.83(P<0.001)。超声显示局灶性神经扩大,特别是在诱捕地点。此外,神经多普勒信号有明显的变化,回声,和测量的神经部位的神经厚度。麻风患者的NfL水平与所有部位的神经横截面积密切相关(P<0.05)。功能和临床评估评分与NfL和超声横截面积相关(P≤0.05)。
结论:非质子性神经病中NfL升高。超声显示麻风病人的特定形态变化,神经肿大与NfL水平相关。因此,这两种模式都可能对诊断有用,预后,以及对患有非质子性神经病的患者进行疾病监测,需要进一步调查。
OBJECTIVE: To explore neurofilament light chain (NfL) levels in leprotic neuropathy compared to controls, and to determine if the changes correlate with ultrasonographic nerve findings.
METHODS: Individuals with leprosy with signs or symptoms suggestive of peripheral nerve involvement were recruited. They were evaluated by clinical examination, functional scores, laboratory assessments (including NfL), nerve conduction studies (NCS), and ultrasound. Ultrasound was conducted in bilateral median, ulnar, tibial, fibular, sural, and vagus nerves as well as cervical roots 5 and 6. Results were compared to age, sex, and body mass index matched healthy controls.
RESULTS: A total of 320 nerves from 20 patients and 480 nerves from 30 controls were evaluated. NfL was significantly elevated in those with leprosy with a mean and standard deviation of 7.50 + 2.83 compared with 3.42 + 1.18 in controls (P < .001). Ultrasound showed focal enlargement of the nerves, particularly at entrapment sites. Additionally, there were noticeable changes in neural Doppler signal, echogenicity, and epineural thickness among the measured nerve sites. NfL levels in those with leprosy correlated closely with nerve cross-sectional area at all sites (P < .05). Functional and clinical assessment scores correlated with NfL and sonographic cross-sectional area as well (P ≤ .05).
CONCLUSIONS: NfL is elevated in leprotic neuropathy. Ultrasound showed specific morphological changes in individuals with leprosy, and nerve enlargement correlated with NfL levels. Thus, both modalities may be useful for the diagnosis, prognosis, and disease monitoring in those with leprotic neuropathy, and further investigations are warranted.