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[糖尿病性神经病变的临床表现与诊断]

[Clinical presentation and diagnosis of diabetic neuropathy].

作者信息

Kempler Péter

机构信息

Altalános Orvostudományi Kar, I. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest.

出版信息

Orv Hetil. 2002 May 19;143(20):1113-20.

Abstract

Autonomic and sensory nerve dysfunction are progressive forms of diabetic neuropathies, often accompanied by other microvascular complications which are usually characterized by gradual onset of symptoms. Mononeuropathies, radiculopathies, motor palsies and acute painful neuropathies are more reversible forms of neuropathies. Their evolution is often unrelated to glycaemic control, vascular factors are more important in the pathogenesis and these complications are more common in middle aged and elderly men with type 2. diabetes mellitus. The diagnosis of neuropathies is based on following criteria: nerve conduction velocity studies; neurological examination; quantitative motor, sensory and autonomic function tests; neuropathic symptoms. Autonomic functions should be evaluated by standard cardiovascular reflex tests. Recently, reliable, however, simple and cheap methods such as the calibrated tuning fork and the monofilament are recommended to use for the diagnosis of sensory nerve dysfunction in everyday clinical practice.

摘要

自主神经和感觉神经功能障碍是糖尿病神经病变的进展形式,常伴有其他微血管并发症,这些并发症通常以症状逐渐出现为特征。单神经病、神经根病、运动麻痹和急性疼痛性神经病是神经病变中更具可逆性的形式。它们的进展通常与血糖控制无关,血管因素在发病机制中更为重要,这些并发症在患有2型糖尿病的中老年男性中更为常见。神经病变的诊断基于以下标准:神经传导速度研究;神经系统检查;定量运动、感觉和自主神经功能测试;神经病变症状。自主神经功能应通过标准的心血管反射测试进行评估。然而,最近推荐在日常临床实践中使用校准音叉和单丝等可靠、简单且廉价的方法来诊断感觉神经功能障碍。

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