Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Austria.
Pediatr Neurol. 2013 Sep;49(3):171-7. doi: 10.1016/j.pediatrneurol.2013.03.014. Epub 2013 Jul 4.
The aim of this study was to evaluate the prevalence of diabetic peripheral neuropathy in children and adolescents with type 1 diabetes mellitus and examine whether the neurological examination validly diagnoses diabetic peripheral neuropathy as compared with the gold standard of nerve conduction velocity in these patients. Nerve conduction velocity was measured in an unselected consecutive series of patients aged 8-18 years who had been suffering from type 1 diabetes mellitus for at least 1 year. For the neurological examination, neuropathy disability scores and neuropathy sign scores were used. Of the 39 patients, six (15%) had clinically evident diabetic peripheral neuropathy, whereas nerve conduction velocity testing revealed diabetic peripheral neuropathy in 15 (38%) patients. Sensitivity and specificity of the neurological examination for the diagnosis of diabetic peripheral neuropathy were 40% and 100%, respectively. The corresponding positive and negative predictive values were 100% and 72.7%, respectively. This conclusions from this study are that in children and adolescents with type 1 diabetes mellitus, diabetic peripheral neuropathy is highly prevalent, but in the majority of patients it is subclinical. Sensitivity and negative predictive values of the neurological examination are low. Therefore, routine nerve conduction velocity measurement for the assessment of diabetic peripheral neuropathy appears to be warranted in these patients.
本研究旨在评估 1 型糖尿病儿童和青少年中糖尿病周围神经病变的患病率，并检验神经检查与神经传导速度这一金标准相比，是否能有效诊断这些患者的糖尿病周围神经病变。在这项未选择性的连续研究中，我们测量了年龄在 8-18 岁、1 型糖尿病病程至少 1 年的患者的神经传导速度。神经检查采用神经病损评分和神经病损体征评分。39 例患者中，6 例（15%）有临床明显的糖尿病周围神经病变，而神经传导速度检查显示 15 例（38%）有糖尿病周围神经病变。神经检查诊断糖尿病周围神经病变的敏感性和特异性分别为 40%和 100%，阳性预测值和阴性预测值分别为 100%和 72.7%。因此，本研究得出的结论是，1 型糖尿病儿童和青少年中糖尿病周围神经病变的患病率很高，但在大多数患者中是亚临床的。神经检查的敏感性和阴性预测值较低。因此，对这些患者进行神经传导速度评估以评估糖尿病周围神经病变似乎是必要的。
