多发性硬化患者神经系统损害程度与自主神经症状量表评分和交感神经皮肤反应异常率的关系

摘要

目的：探讨多发性硬化（ MS）患者神经系统损害程度与自主神经症状量表（ ASP）评分和交感神经皮肤反应（ SSR）异常率的关系。方法62例MS患者（ MS组）和36例健康对照者（对照组）分别进行ASP问卷调查并记录各子项目分值。 MS组根据扩展致残量表评分分为轻度损害组（0～4分）和重度损害组（4．5～9．5分），分别进行SSR检测。结果 MS组与对照组ASP评分的差异有统计学意义（t＝7．962，P＜0.001）。两组ASP评分各子项目中差异有统计学意义的子项目为直立不耐受、分泌功能障碍、男性功能障碍、排尿障碍、胃轻瘫、便秘、瞳孔运动障碍、血管舒缩功能障碍、反射性晕厥（均P＜0.05）。 MS组患者中，轻度损害组ASP评分及SSR异常率均明显低于重度损害组（t＝9．069，P＜0.001；χ2＝16．16，P＜0.001）。结论ASP可用于评估MS自主神经系统损害的临床特征和全貌。 MS患者神经系统损害程度与其ASP评分及SSR异常率均有关。%Objective To observe the relationship between the degree of nervous system damage and autonomic symptom profile (ASP) score, sympathetic skin response ( SSR) abnormal rate in patients with multiple sclerosis ( MS) .Methods Sixty-two MS patients ( MS group) and 36 controls ( control group) were questionnaire surveyed using ASP and each subitem score was recorded.According the score of expanded disability scale, MS patients were divided into minor disability group and sever disability group.SSR were studied in MS patients respectively.Results There was significant difference in ASP score between MS group and control group (t =7.962, P<0.001). Among subitem of ASP, the score of orthostatic intolerance, pathocrine, male sexual dysfunction, urination disorders, gastroparesis, constipation, pupillomotor dysfunction, vasomotor dysfunction and reflexsyncope were significant differences between two groups (all P<0.05).Among MS patients, ASP score and the abnormal rate of SSR in minor disability group were significantly lower than sever disability group ( t=9.069,P<0.001;χ2 =16.16, P<0.001).Conclusions ASP can be applied to assess autonomic dysfunction and feature in multiple sclerosis patients.ASP score and the abnormal rate of SSR are related to nervous system damage in MS patients.