IR@PKUHSC  > 北京大学第一临床医学院  > 神经内科
学科主题神经病学
替比夫定与聚乙二醇干扰素α-2a联用导致感觉神经病二例
其他题名Combined therapy of telbivudine and pegylated interferon α-2a induced sensory neuropathy:2 case reports
郑日亮; 张巍; 袁云
关键词替比夫定 聚乙烯二醇类 干扰素α-2a 中毒 药物疗法 周围神经系统疾病 联合 Telbivudine Polyethylene Glycols Interferon Alfa-2a Poisoning Drug Therapy Peripheral Nervous System Diseases Combination
刊名中华神经科杂志
2009
DOI10.3760/cma.j.issn.1006-7876.2009.07.012
42期:7页:475-478
收录类别中国科技核心期刊 ; CSCD
文章类型Journal Article
摘要目的 报道2例使用替比夫定和聚乙二醇干扰素α-2a联合治疗乙型肝炎导致的感觉神经病患者,对其临床、电生理和病理改变规律进行讨论.方法 2例男性患者分别为48岁和20岁,均为慢性乙型肝炎病毒感染者,在应用替比夫定和聚乙二醇干扰素α-2a治疗4个月后出现双下肢麻木和疼痛,症状进行性加重.体检发现均出现四肢远端痛觉减退,例2出现腱反射减低.2例均出现四肢远端无汗,例1出现手指和足趾的甲根部灰白样改变.例2伴随出现下肢轻度肌力下降和血清肌酸激酶轻度升高.对2例患者进行电生理检查及腓肠神经病理检查.结果 2例患者的电生理检查发现感觉神经动作电位波幅显著减低,传导速度轻度下降,其中1例出现运动神经动作电位波幅减低.腓肠神经活体组织检查显示有髓神经纤维中度减少、有髓神经纤维轴索变性和轻度再生簇形成.电镜检查进一步发现无髓神经纤维也出现减少.停止药物治疗并给予B族维生素、辅酶Q10和左旋肉碱治疗后症状好转.结论 替比夫定联合聚乙二醇干扰素α-2a治疗可以导致感觉神经病,出现轴索性神经病的电生理和病理改变特点.此病具有可逆性. Objective To report the clinical and pathological features of the sensory neuropathy caused by a combined therapy of telbivudine and pegylated interferon α-2a in 2 patients with hepatitis B virus infection Methods Two male patients aged 48(case 1)and 20(case 2),who suffered from hepatitis B virus infection.were given telbivudine and pegylated interferon α-2a.After 4 months treatment,both patients developed numbness and pain in the lower limbs.The physical examination showed decreased pain sensation in distal extremities.Hypahidrosis appeared in distal extremities.The nails were pale changed in fingers and toes in cage 1.Case 2 presented mild weakness in the proximal muscle of lower limbs and the tendon reflex was decreased in both lower limbs.His 8erunl creatine kinase level was mild elevated.The electromyography examination and sural nerve biopsies were performed on both patients.Results Electromyography examination showed significant decrease of amplitude of sensory nerve action potentials and mild decrease of sensory nerve conduction velocities in both patients.The amplitude of motor nerve action potentials was also decreased in case 2.Light microscope examination revealed middle reduction of myelinated fibers,wallerian degeneration of myelinated fibers and small clusbers of regenerated fibers in sural nerve.Electro microscopy examination revealed the loss of unmyehnated nerve fibers.After the combined therapy was stopped and vitamin B,CoQ10 and L-camitine were administered,the patients recovered gradually.Conclusions Combined therapy of telbivudine and pegylated interferon α-2a may cause sensory neuropathy with electrophsiological and pathological abnormalities of axonal lesions.The sensory neuropathy induced by the combined therapy may be reversible.
语种中文
原文出处查看原文
引用统计
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/41518
专题北京大学第一临床医学院_神经内科
作者单位北京大学第一医院神经内科,100034
推荐引用方式
GB/T 7714
郑日亮,张巍,袁云. 替比夫定与聚乙二醇干扰素α-2a联用导致感觉神经病二例[J]. 中华神经科杂志,2009,42(7):475-478.
APA 郑日亮,张巍,&袁云.(2009).替比夫定与聚乙二醇干扰素α-2a联用导致感觉神经病二例.中华神经科杂志,42(7),475-478.
MLA 郑日亮,et al."替比夫定与聚乙二醇干扰素α-2a联用导致感觉神经病二例".中华神经科杂志 42.7(2009):475-478.
条目包含的文件
条目无相关文件。
个性服务
推荐该条目
保存到收藏夹
查看访问统计
导出为Endnote文件
谷歌学术
谷歌学术中相似的文章
[郑日亮]的文章
[张巍]的文章
[袁云]的文章
百度学术
百度学术中相似的文章
[郑日亮]的文章
[张巍]的文章
[袁云]的文章
必应学术
必应学术中相似的文章
[郑日亮]的文章
[张巍]的文章
[袁云]的文章
相关权益政策
暂无数据
收藏/分享
所有评论 (0)
暂无评论
 

除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。