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Основные метаболические и токсические полинейропатии в клинической практике

https://doi.org/10.21518/2079-701X-2021-19-134-146

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Аннотация

Полинейропатии – это заболевания периферической нервной системы с поражением моторных, сенсорных и/или вегетативных волокон, с которыми сталкиваются лечащие врачи практически всех специальностей амбулаторно и в клиниках. К настоящему времени выявлено более 100 различных причин развития полинейропатий. В группе вторичных полинейропатий наиболее часто приходится сталкиваться с метаболическими и токсическими полинейропатиями. Среди этих заболеваний лидирующее место занимают диабетические, алкогольные, уремические и лекарственно-индуцированные полинейропатии. Представлены основные формы диабетической полинейропатии. Основной клинической формой является дистальная симметричная полинейропатия. Клинические симптомы зависят от вида вовлеченных в патологический процесс волокон – тонких или толстых. Дана оценочная шкала в баллах для определения выраженности диабетической полинейропатии, что помогает в уточнении диагноза и прогноза заболевания. Следующей по частоте встречаемости среди метаболических полинейропатий является уремическая полинейропатия как наиболее частое осложнение у пациентов, страдающих хронической почечной недостаточностью. Описаны факторы риска развития уремической полинейропатии, клиническая картина, течение заболевания. В рамках токсических полинейропатий основное место уделено алкогольным полинейропатиям, вызванным химиотерапией и лекарственно-индуцированным. Для каждой из этих категорий описаны клинические формы, патофизиология развития. Для всех полинейропатий представлены основные диагностические аспекты. Показаны основные терапевтические подходы. Отдельное место отведено применению альфа-липоевой кислоты.

Об авторе

Н. В. Пизова
Ярославский государственный медицинский университет
Россия

Пизова Наталия Вячеславовна, д.м.н., профессор, профессор кафедры нервных болезней с медицинской генетикой и нейрохирургией

150000, Россия, Ярославль, ул. Революционная, д. 5



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Пизова Н.В. Основные метаболические и токсические полинейропатии в клинической практике. Медицинский Совет. 2021;(19):134-146. https://doi.org/10.21518/2079-701X-2021-19-134-146

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Pizova N.V. Main metabolic and toxic polyneuropathies in clinical practice. Meditsinskiy sovet = Medical Council. 2021;(19):134-146. (In Russ.) https://doi.org/10.21518/2079-701X-2021-19-134-146

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