張楊全2006-07-262018-07-122006-07-262018-07-122000http://ntur.lib.ntu.edu.tw//handle/246246/26082Pathological diagnosis of small-fiber neuropathy has traditionally depended on ultrastructural examinations of nerve biopsy specimens. To investigate the potential of epidermal nerve evaluation as a diagnostic approach, we performed 3-mm punch skin biopsies on healthy controls and patients with sensory neuropathy. Epidermal nerves were demonstrated by immunocytochemistry with the axonal marker, protein gene product 9.5. Patients with sensory neuropathy had both qualitative and quantitative features suggestive of cutaneous nerve degeneration. Degenerated dermal nerves exhibited a characteristic beaded appearance. Epiderrnal nerve density in the distal leg of healthy controls was 12.92±5.33 fibers/mm (mean±SD), and the value was markedly reduced in patients with sensory neuropathies, at 1.80 ¡Ó 3.16 fibers/mm (p <0.001). The results provide pathological criteria to interpret skin biopsies and also suggest that evaluation of epidermal innervation by skin biopsy is a feasible diagnostic approach with minimal invasiveness.負責傳遞冷、熱、痛等刺激的成覺神經末梢位於皮膚的淺層，這些成覺神經通常非常的微小，一般的研究必須借助電子顯微鏡，也因如此，過去數十年來，有關這方面的研究非常少。在電子顯微鏡的層次要研究這些神經，通常就須施行神經切片，神經切月是一侵襲性甚高的檢查，因此病人的接受度不太高，在這種情況下，要研究或是診斷有關周邊神經的病變就是一個很大的盲點。本研究試圖建立以皮膚切月為基礎的病理檢查，於一般光學顯微鏡層次就可以評估位於表皮層之成覺神經末梢的退化。直徑3 釐米之皮膚切月，以protein gene product 9.5 ( PGP 9.5 ）的免疫化學染色，經過影像分析系統定量，正常人的表皮神經密度（epidermal nerve density ）為12.92±5.33 fibers / mm , 明顯降低（P < 0.001 ）。本研究顯示皮膚切月合併免疫化學染色及表皮神經之定量分析，可用以診斷小纖維成覺神經病變。application/pdf821199 bytesapplication/pdfzh-TW國立臺灣大學醫學院神經科Epidermal nervesSkin biopsySmall-fiber neuropathySkin innervationNerve degenerationjournal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/26082/1/892314B002144.pdf