周围神经病评分量表的临床应用综述

doi:10.3969/j.issn.1674-8115.2021.11.018

摘要/Abstract

摘要：

周围神经病（peripheral neuropathy，PN）是指周围运动、感觉和自主神经的功能障碍和结构改变所致的一组疾病。用于筛查与评估PN的量表不断在临床中应用。该文归纳慢性炎症性脱髓鞘性多发性神经根神经病、腓骨肌萎缩症、糖尿病性PN和神经病理性疼痛4种常见PN的评分量表，旨在提高医务人员对这4种PN评分量表的认识和应用能力。

关键词: 评分量表, 慢性炎症性脱髓鞘性多发性神经根神经病, 腓骨肌萎缩症, 糖尿病性周围神经病, 神经病理性疼痛

Abstract:

Peripheral neuropathy (PN) refers to a group of diseases caused by the dysfunction and structural changes of peripheral motor, sensory and autonomic nerves. Scales for screening and assessing PN are continuously being used in clinical practice. This article summarizes PN score scales for four kinds of PN, including chronic inflammatory demyelinating polyradiculoneuropathy, Charcot-Marie-Tooth disease, diabetic PN and neuropathic pain, aiming to improve medical staff's understanding and application ability of the PN assessment scale.

Key words: assessment scale, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), Charcot-Marie-Tooth disease (CMT), diabetic peripheral neuropathy (DPN), neuropathic pain (NP)

中图分类号:

R745

汪群峰, 曹立, 栾兴华. 周围神经病评分量表的临床应用综述[J]. 上海交通大学学报(医学版), 2021, 41(11): 1518-1523.

Qun-feng WANG, Li CAO, Xing-hua LUAN. Review of clinical application of peripheral neuropathy scales[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(11): 1518-1523.

图/表 2

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Scale	Sensitivity/%	Specificity/%	Accuracy/%	Reference
MNSI	78.00	92.00	83.00	［26］
MDNS	92.90	51.60	82.90	［25］
NSC	85.96	77.03	80.92	［19］
NIS	59.65	98.65	81.68	［19］
TCSS	77.60	87.10	79.80	［25］

Scale	Sensitivity/%	Specificity/%	Accuracy/%	Reference
MNSI	78.00	92.00	83.00	［26］
MDNS	92.90	51.60	82.90	［25］
NSC	85.96	77.03	80.92	［19］
NIS	59.65	98.65	81.68	［19］
TCSS	77.60	87.10	79.80	［25］

Type of PN	Scale	Evaluation item	Average completion time/min	Clinical application	Pros and cons	Reference
CIDP	I-RODS	24 items	2–3	Applicable to all CIDP	Advantages： high responsiveness， can accurately distinguish the degree of disability， there is no floor effect， and the slightest recurrence can be captured. Disadvantage： there is a ceiling effect	［5， 8］
	ONLS	An arm disability scale and a leg disability scale	4–5	CIDP degree of disability	Advantages： fast， simple， good content validity， small upper limit effect	［11］
CMT	CMTNS	9 items	3	Length-dependent motor and sensory impairments in hereditary neuropathy， quantifying CMT disability	Advantages： reliability， effectiveness. Disadvantages： there are limitations in the use of length-independent multifocal diseases； changes in age will increase the score	［14-16］
	CMTNS2	9 items	3	Quantify CMT disability and standardize assessment	Advantages： the upper and lower limit effects are low， and the sensitivity of detection over time is high	［15］
DPN	MNSI	15 questions and 8 physical examinations	4–5	Early large-scale screening to monitor the progress of the disease	Advantages： simple， fast， and feasible. Disadvantages： unable to identify subclinical and autonomic neuropathy	［27-30，33］
	MDNS	20 items	15	Diagnosis and staging	Advantages： fast and sensitive	［33-34］
	TCSS	13 items	11	Early screening and diagnosis， early DPN treatment evaluation	Advantages： early monitoring methods	［20］
	COMPASS-31	31 items	10	Early detection and management of CAN	Advantages： short time， convenient and high sensitivity	［36，38-39］
NP	DN4	10 items	2.5	Neuropathic pain screening	Advantages： strong screening ability	［41-44，49］

Type of PN	Scale	Evaluation item	Average completion time/min	Clinical application	Pros and cons	Reference
CIDP	I-RODS	24 items	2–3	Applicable to all CIDP	Advantages： high responsiveness， can accurately distinguish the degree of disability， there is no floor effect， and the slightest recurrence can be captured. Disadvantage： there is a ceiling effect	［5， 8］
	ONLS	An arm disability scale and a leg disability scale	4–5	CIDP degree of disability	Advantages： fast， simple， good content validity， small upper limit effect	［11］
CMT	CMTNS	9 items	3	Length-dependent motor and sensory impairments in hereditary neuropathy， quantifying CMT disability	Advantages： reliability， effectiveness. Disadvantages： there are limitations in the use of length-independent multifocal diseases； changes in age will increase the score	［14-16］
	CMTNS2	9 items	3	Quantify CMT disability and standardize assessment	Advantages： the upper and lower limit effects are low， and the sensitivity of detection over time is high	［15］
DPN	MNSI	15 questions and 8 physical examinations	4–5	Early large-scale screening to monitor the progress of the disease	Advantages： simple， fast， and feasible. Disadvantages： unable to identify subclinical and autonomic neuropathy	［27-30，33］
	MDNS	20 items	15	Diagnosis and staging	Advantages： fast and sensitive	［33-34］
	TCSS	13 items	11	Early screening and diagnosis， early DPN treatment evaluation	Advantages： early monitoring methods	［20］
	COMPASS-31	31 items	10	Early detection and management of CAN	Advantages： short time， convenient and high sensitivity	［36，38-39］
NP	DN4	10 items	2.5	Neuropathic pain screening	Advantages： strong screening ability	［41-44，49］

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