Sosenko Jay
University of Miami, School of Medicine, P.O. Box 016960 (R-53), Miami, FL 33101, USA.
Curr Diab Rep. 2002 Dec;2(6):477-81. doi: 10.1007/s11892-002-0116-0.
There is now substantial evidence that diabetic neuropathy is a major etiologic factor for diabetic foot ulcers. Epidemiologic data show a very strong association between foot ulcers and indicators of sensorimotor neuropathy. Additionally, a causal pathway (sensorimotor neuropathy, which leads to increased pressures at foot surfaces, which then leads to foot ulcers) has been postulated. Evidence suggests that other factors also contribute to foot ulcer risk through an interaction with neuropathy such as foot deformity, footwear, and body weight. There has been an effort to optimize modalities for screening diabetic patients for hypoesthesia in order to prevent foot ulcers; however, there have not been definitive prospective studies that have compared the effectiveness of available tests.
现在有大量证据表明，糖尿病神经病变是糖尿病足溃疡的主要病因。流行病学数据显示，足部溃疡与感觉运动神经病变指标之间存在非常强的关联。此外，还提出了一条因果途径（感觉运动神经病变导致足部表面压力增加，进而导致足部溃疡）。有证据表明，其他因素也通过与神经病变的相互作用（如足部畸形、鞋类和体重）增加足部溃疡风险。为了预防足部溃疡，人们一直在努力优化糖尿病患者感觉减退的筛查方式；然而，尚未有确定性的前瞻性研究比较现有检测方法的有效性。
