Neurophysiological Changes in Patients with Chronic Obstructive Pulmonary Diseases

Yıl 2014, Cilt: 11 Sayı: 3, - , 01.09.2014

Recep Demir Lütfi Özel Gökhan Özdemir İdris Kocatürk Hızır Ulvi

https://doi.org/10.15197/sabad.1.11.61

Öz

Peripheral neuropathy commonly occurs in patients with chronic obstructive lung disease (COPD). The aim of our study was to investigate the possible effects of COPD on the peripheral nervous system. We enrolled 31 patients (16 women and 15 men), mean age 66.12, with COPD into the study. Arterial oxygen tension (PaO2)> or = 65 mmHg was considered as the cut-off value designating tissue hypoxia. According to this cut-off value, the subjects were divided into two groups: Group I (n=16), PaO2< 65 mmHg and Group II (n=15), PaO2> or = 65 mmHg. In all patients and controls, motor and sensory nerve conductions were studied with an electromyogram (EMG). We detected neuropathy in 93,5% of the study patients on EMG. In the Group I, severity of neuropathy was correlated with the degree of hypoxemia, but no correlation was observed in the Group II. In conclusion, the incidence of sensorial neuropathy was more than expected, the rate of axonal neuropathy was significantly higher in the group I than group II and the severity of neuropathy was correlated with the degree of hypoxemia in group I. From these data we suggest that electrophysiological studies may be useful in assessing the peripheral neuropathy in patients with COPD.

Anahtar Kelimeler

Pulmonary disease, electrophysiological study, peripheral neuropathy, nerve conduction, hypoxemia

Neurophysiological Changes in Patients with Chronic Obstructive Pulmonary Diseases

Öz

Kronik obstrüktif akciğer hastalığı olan hastalarda (KOAH) periferik nöropati yaygın olarak görülmektedir. Çalışmamızın amacı KOAH’ın periferik sinir sistemi üzerine olan muhtemel etkilerini incelemekti. Çalışmamızda 31 hastayı inceledik. Bunların 16’sı kadın, 15’i erkek ve yaş ortalama 66.12 idi. Arteriyal oksijen basıncının > veya = 65 mmHg olarak doku hipoksisini belirleyen cut-off değeri olarak alındı. Bu cut-off değerine göre, kişiler Grup I (n=16), PaO2 < 65 mmHg ve Grup II (n=15), PaO2 > veya = 65 mmHg ikiye ayrıldı. Hasta ve kontrol grubunda, motor ve duysal sinir ileti çalışmaları elektromyografi (EMG) ile değerlendirildi.Çalışmamızda hastaların %93.5’inde EMG’de nöropati tesbit edildi. Grup I’deki hastalarda nöropati şiddeti ile hipoksinin derecesi arasında ilişki mevcuttu, ancak Grup II’deki hastalarda böyle bir ilişki saptanmadı. Duysal nöropati insidansı beklenenden daha fazlaydı. Aksonal nöropati oranı Grup I’de, Grup II’ye göre anlamlı olarak daha yüksek gözlendi. Grup I’de nöropatinin şiddeti, hipokseminin derecesi ile ilişkiliydi. Bu veriler ışığında, biz KOAH’lı hastalarda periferik nöropatinin elektrofizyolojik incelenmesinin yararlı olabileceğini öneriyoruz

Anahtar Kelimeler

Akciğer Hastalığı, elektrofizyolojik inceleme, periferik nöropati, sinir iletimi, hipoksemi

Kaynakça

• Gupta PP and Agarwal D. Chronic obstructive pulmonary disease and peripheral neuropathy. Lung India 2006; 23:25-33.
• Kayacan O, Beder S, Deda G, Karnak D. Neurophysiological changes in COPD patients with chronic respiratory insuf- ficiency. Acta Neurol Belg 2001; 101: 160-5.
• Klocke RA, Arterial blood gases, Baum GL, Wolinsky E, Editors; Textbook of Pulmonary Diseases, Little, Brown and Company, Boston/Toronto (1989), p. 147 (Chapter 8).
• Jindal SK, Gupta D, Aggarwal AN; WHO-Government of India Biennium (2002-2003) Programme. Guidelines for the management of chronic obstructive pulmonary dis- ease (COPD) in India: a guide for physicians (2003). Indian J Chest Dis Allied Sci 2004; 46:137-53.
• Poza JJ and Martí-Massó JF. Peripheral neuropathy as- sociated with chronic obstructive pulmonary disease. Neurologia 1997; 12: 389-94.
• Stoebner P, Mezin P, Vila A, et al. Microangiopathy of en- doneurial vessels in hypoxemic chronic obstructive pul- monary disease (COPD). A quantitative ultrastructural study. Acta Neuropathol (Berl) 1989; 78: 388-95.
• Mayer P, Dematteis M, Pépin JL, et al. Peripheral neu- ropathy in sleep apnea. A tissue marker of the severity of nocturnal desaturation. Am J Respir Crit Care Med 1999; 159: 213-9.
• Ludemann P, Dziewas R, Soros P, Happe S, Frese A. Axonal polyneuropathy in obstructive sleep apnoea. J Neurol Neurosurg Psych 2001; 70(5):685–7.
• Low PA, Schmelzer JD, Ward KK, et al. Experimental chronic hypoxic neuropathy: relevance to diabetic neu- ropathy. Am J Physiol 1986; 250: 94–9.
• Agrawal D, Vohra R, Gupta PP, Sood S. Subclinical pe- ripheral neuropathy in stable middle-aged patients with chronic obstructive pulmonary disease. Singapore Med J 2007; 48 (10) : 887.
• Ozge A, Atis S, SevimS. Subclinical peripheral neuropathy associated with chronic obstructive pulmonary disease. Electromyogr Clin Neurophysiol 2001; 41(3): 185–91.
• Jann S, Gatti A, Crespi S, Rolo J, Beretta S. Peripheral neuropathy in chronic respiratory insufficiency. J Peripher Nerv Syst 1998; 3: 69-74.
• Öncel C, Baser S, Çam M, et al. Peripheral Neuropathy in Chronic Obstructıve Pulmonary Disease. COPD 2010; 7:11–6.