Coppack S W, Watkins P J
Diabetic Department, King's College Hospital, London.
Q J Med. 1991 Apr;79(288):307-13.
Diabetic femoral neuropathy is an uncommon, unpleasant and sometimes disabling condition, on account of both pain and muscular atrophy, whose long-term prognosis has not previously been documented. We have reviewed a group of 27 patients up to 14 years (median 62 months) after diagnosis; 18 of these were re-examined after an average of nearly 4 years (median 45 months). The condition was more common in non-insulin-dependent diabetics (88 per cent), in men (59 per cent) and in older patients (median age at diagnosis 64 years). The neuropathy was bilateral (10 cases) or unilateral (17 cases); five patients with unilateral neuropathy developed femoral neuropathy on the opposite side, usually within a few weeks of the first episode. Recovery was apparent after 3 months and usually complete by 18 months; only two of the 27 patients had severe relapses. No patients remained disabled, although there were minor residual symptoms and signs in half of the patients (2 cm reduction in thigh circumference and diminished reflexes). The outlook for femoral neuropathy, even in its most severe form, is therefore very good: residual features are demonstrable but do not cause symptoms, and relapses after the first few weeks are very rare.
糖尿病性股神经病变是一种不常见、令人不适且有时会导致残疾的病症，因其疼痛和肌肉萎缩，此前尚未有关于其长期预后的记录。我们回顾了一组27例患者，从诊断后长达14年（中位时间62个月）；其中18例在平均近4年（中位时间45个月）后接受了复查。该病症在非胰岛素依赖型糖尿病患者中更为常见（88%），男性患者居多（59%），且多见于老年患者（诊断时的中位年龄为64岁）。神经病变为双侧（10例）或单侧（17例）；5例单侧神经病变患者在首次发作后的几周内，通常在对侧出现股神经病变。3个月后恢复明显，通常在18个月时完全恢复；27例患者中只有2例出现严重复发。尽管半数患者（大腿周长减少2厘米，反射减弱）有轻微的残留症状和体征，但没有患者仍处于残疾状态。因此，即使是最严重形式的股神经病变，其预后也非常好：残留特征明显，但不会引起症状，且在最初几周后复发非常罕见。
