振動障害患者の体性および自律神経機能

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In order to evaluate the functions of the peripheral somatic nerve and autonomic nerve in patients with occupational vibration disease objectively and quantitatively, four examinations were performed on twenty 44-63yr old patients with occupational vibration disease and their total operating time ranged from 5,000 to 43,750h. 1) Motor nerve conduction velocities (MCV) and sensory nerve conduction velocities (SCV) of the ulnar and median nerves were measured using conventional methods. 2) Electrogustatory thresholds under the controlled area of the chorda tympani nerve were measured by Tomita's method using an electrogustometer (610-M, M.E.C.). 3) Dopamine-β-hydroxylase (DBH) activity in blood was assayed by the photometric assay of Nagatsu and Udenfriend. 4) Coefficient of variation of R-R interval in ECG (CV_<R-R>) was measured after 15-min-resting in supine position by using a R-R interval analyzer (Autonomic R 100, M.E.C.). The results of these examinations were compared with those of special examinations for the diagnosis of vibration disease. In patients with occupational vibration disease, MCV and SCV of the ulnar and median nerve were lower in value than those in age-matched healthy controls. In particular, MCV of the ulnar nerve, MCV and SCV of the median nerve were significantly lower in the patients than in the controls. Nerve conduction velocities were significantly correlated with skin temperature and nailpress test, though diminished nerve conduction velocities observed in vibration disease patients were considered to be attributable to peripheral circulatory disturbance. Electrogustatory thresholds under the controlled area of the chorda tympani nerve in the patients were significantly higher than those in age-matched healthy controls, suggesting that the gustatory function was disturbed in patients with vibration disease. DBH activities in patients with vibration disease were significantly higher than those in healthy controls, suggesting that the sympathetic nerve function was accelerated in the patients. CV R-R in the patients was significantly lower than in age-matched healthy controls. It was suggested that the function of the parasympathetic nerve (especially the cardiac branch of vagus) was decreased in patients with vibration disease. These findings suggest that these examinations are useful in elucidating the pathogenesis of vibration disease.
社団法人日本産業衛生学会の論文
1987-11-20

振動障害患者の体性および自律神経機能

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