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使用动态瞳孔测量法作为一种简单的筛查工具来检测糖尿病患者的自主神经病变：一项初步研究。

Using dynamic pupillometry as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study.

机构信息

School of Electrical Engineering and Applied Computer Sciences-CPGEI, Federal University of Technology-Paraná, Curitiba, PR - Brazil.

出版信息

Biomed Eng Online. 2010 Jun 17;9:26. doi: 10.1186/1475-925X-9-26.

DOI:10.1186/1475-925X-9-26
PMID:20565794
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2893537/
Abstract

BACKGROUND

Autonomic neuropathy is a common and serious complication of diabetes. Early detection is essential to enable appropriate interventional therapy and management. Dynamic pupillometry has been proposed as a simpler and more sensitive tool to detect subclinical autonomic dysfunction. The aim of this study was to investigate pupil responsiveness in diabetic subjects with and without cardiovascular autonomic neuropathy (CAN) using dynamic pupillometry in two sets of experiments.

METHODS

During the first experiment, one flash was administered and the pupil response was recorded for 3 s. In the second experiment, 25 flashes at 1-s interval were administered and the pupil response was recorded for 30 s. Several time and pupil-iris radius-related parameters were computed from the acquired data. A total of 24 diabetic subjects (16 without and 8 with CAN) and 16 healthy volunteers took part in the study.

RESULTS

Our results show that diabetic subjects with and without CAN have sympathetic and parasympathetic dysfunction, evidenced by diminished amplitude reflexes and significant smaller pupil radius. It suggests that pupillary autonomic dysfunction occurs before a more generalized involvement of the autonomic nervous system, and this could be used to detect early autonomic dysfunction.

CONCLUSIONS

Dynamic pupillometry provides a simple, inexpensive, and noninvasive tool to screen high-risk diabetic patients for diabetic autonomic neuropathy.

摘要

背景

自主神经病变是糖尿病的一种常见且严重的并发症。早期发现对于进行适当的干预治疗和管理至关重要。动态瞳孔测量法被提出作为一种更简单、更敏感的工具，用于检测亚临床自主功能障碍。本研究的目的是使用动态瞳孔测量法在两组实验中研究伴有和不伴有心血管自主神经病变（CAN）的糖尿病患者的瞳孔反应。

方法

在第一个实验中，给予一次闪光刺激，并记录 3 秒的瞳孔反应。在第二个实验中，以 1 秒的间隔给予 25 次闪光刺激，并记录 30 秒的瞳孔反应。从获得的数据中计算了几个时间和瞳孔虹膜半径相关参数。共有 24 名糖尿病患者（16 名无 CAN 和 8 名有 CAN）和 16 名健康志愿者参与了研究。

结果

我们的结果表明，伴有和不伴有 CAN 的糖尿病患者存在交感和副交感神经功能障碍，表现为反射幅度减小和瞳孔半径明显减小。这表明瞳孔自主神经功能障碍发生在自主神经系统更广泛受累之前，这可能用于检测早期自主神经功能障碍。

结论

动态瞳孔测量法提供了一种简单、廉价、非侵入性的工具，可用于筛查高危糖尿病患者的糖尿病自主神经病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f059/2893537/e45253cb4e75/1475-925X-9-26-10.jpg
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