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[2型糖尿病患者周围神经病变的发病率及发展的相互依存关系]

[Incidence and developmental interdependence of peripheral nerve disorders in type 2 diabetics].

作者信息

Kalita Z, Gatková A, Gregorová A, Adamíková A

出版信息

Cas Lek Cesk. 1989 Oct 27;128(43-44):1357-60.

PMID:2598249
Abstract

In 1987-1988 160 type 2 diabetics, dispensarized in diabetological out-patient departments of the medical clinic of the Institute for Postgraduate training were subjected to neurological examinations. The selection of the group was governed by an effort to reduce to a minimum the association of other neurotoxic influences. The group therefore comprised subjects under 60 years of age; diabetics with other diseases with a possible neurotoxic action, drug abuse, alcohol abuse, etc. were eliminated. After a detailed neurological examination signs of affection of the peripheral nervous system were detected in 87.5%, clinically manifest diabetic neuropathy was found in 78 diabetics (48.75%); 12 had moreover mononeuropathy of the median nerve. The clinical picture was uniform: impaired perception of vibrations on the acra of the lower extremities with ascendent propagation, reduction to disappearance tendinous-muscular reflexes on the lower extremities. Subjectively more frequently cramps of the feet than paraesthesias were reported. The authors revealed that long-term compensation of diabetes, the duration of diabetes and the biological age of the diabetics were statistically significant for the manifestation of diabetic neuropathy. This significance was proved for the factor of biological age (p less than 0.05); there was also a significant correlation between the long-term state of compensation of type 2 diabetes and the manifestation of neuropathy (p = 0.06).

摘要

1987年至1988年期间,对160名2型糖尿病患者进行了神经学检查,这些患者在研究生培训学院医学诊所的糖尿病门诊接受治疗。该组的选择旨在尽量减少其他神经毒性影响的关联。因此,该组包括60岁以下的受试者;患有其他可能具有神经毒性作用疾病、药物滥用、酒精滥用等的糖尿病患者被排除在外。经过详细的神经学检查,发现87.5%的患者存在周围神经系统受累迹象,78名患者(48.75%)出现临床明显的糖尿病神经病变;此外,12名患者患有正中神经单神经病。临床表现一致:下肢末端振动觉受损并向上蔓延,下肢腱反射减弱至消失。主观上,报告足部痉挛比感觉异常更为常见。作者发现,糖尿病的长期代偿情况、糖尿病病程以及糖尿病患者的生物学年龄对糖尿病神经病变的表现具有统计学意义。生物学年龄因素的这一意义得到了证实(p<0.05);2型糖尿病的长期代偿状态与神经病变的表现之间也存在显著相关性(p = 0.06)。

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