Kovac Biserka, Kovac Branislav, Marusić-Emedi Slavica, Svalina Sanja, Demarin Vida
Department of Neurology, Vukovar General Hospital, Vukovar, Zagreb, Croatia.
Acta Clin Croat. 2011 Jun;50(2):149-57.
Diabetic polyneuropathy occurs in around 50% of diabetic patients. Its pathophysiological mechanism is not completely clarified and major occurrences boil down to the change in neural phenotype and vasa nervorum. As glucose neurotoxicity has been suggested by plenty of evidence, the aim of the study was to assess the effect of glycemia on the severity of diabetic polyneuropathy. Considering that some practical experiences point to serious complications in patients suffering from diabetes of shorter duration, another aim was to assess the effect of diabetes duration on the severity of related neuropathy. Clinical and electromyoneurographic examinations were performed in 100 patients with diabetic polyneuropathy free from any laboratory signs of renal failure. The effect of HbA1c value and duration of disease on clinical symptoms, signs and electrophysiological indicators of polyneuropathy was analyzed. Study results indicated that 78% of patients with diabetic polyneuropathy did not have well-regulated glycemia. Diabetes duration was associated with a growing number of sensory symptoms, among which the sensation of pain similar to electric shock was present in 63% of patients. In addition, it also had negative impact on the sensory and motor nerve conduction velocity. HbA1c influenced the whole range of electrophysiological indicators of diabetic polyneuropathy.
约50%的糖尿病患者会发生糖尿病性多发性神经病变。其病理生理机制尚未完全阐明，主要发病原因可归结为神经表型和神经血管的改变。鉴于大量证据表明存在葡萄糖神经毒性，本研究的目的是评估血糖水平对糖尿病性多发性神经病变严重程度的影响。考虑到一些实际经验表明病程较短的糖尿病患者会出现严重并发症，另一个目的是评估糖尿病病程对相关神经病变严重程度的影响。对100例无任何肾衰竭实验室指标的糖尿病性多发性神经病变患者进行了临床和肌电图神经检查。分析了糖化血红蛋白（HbA1c）值和病程对神经病变的临床症状、体征及电生理指标的影响。研究结果表明，78%的糖尿病性多发性神经病变患者血糖控制不佳。糖尿病病程与感觉症状数量增加有关，其中63%的患者有类似电击样的疼痛感。此外，它还对感觉和运动神经传导速度有负面影响。HbA1c影响糖尿病性多发性神经病变的所有电生理指标。
