Dyck P J, O'Brien P C
Peripheral Neuropathy Research Laboratory, Mayo Clinic, Rochester, Minnesota 55905.
Diabetes Care. 1989 Oct;12(9):649-52. doi: 10.2337/diacare.12.9.649.
Use of nerve conduction in assessing therapy in preventing or ameliorating neuropathy is desirable because abnormalities of nerve conduction are associated with severity of neuropathic symptoms and deficits. Assuming that a therapy is associated with a statistically significant improvement of nerve conduction, what degree of nerve conduction change is clinically meaningful? We suggest that in controlled clinical trials, a mean change of 2 points on the neurologic disability score is clinically detectable and meaningful. Based on our previously published cross-sectional epidemiological data, this corresponds to a change of motor nerve conduction velocity of the average ulnar median and peroneal nerves of 2.9 m/s and peroneal nerve of 2.2 m/s. The corresponding changes of amplitude were 1.2 and 0.7 mV, respectively. Smaller degrees of nerve conduction change were found when only insulin-dependent patients were evaluated.
利用神经传导来评估预防或改善神经病变的治疗方法是可取的，因为神经传导异常与神经病变症状和缺陷的严重程度相关。假设一种治疗方法与神经传导的统计学显著改善相关，那么多大程度的神经传导变化在临床上是有意义的呢？我们建议在对照临床试验中，神经功能障碍评分平均变化2分在临床上是可检测到且有意义的。根据我们之前发表的横断面流行病学数据，这相当于尺神经、正中神经和腓总神经平均运动神经传导速度变化2.9米/秒，腓总神经变化2.2米/秒。相应的波幅变化分别为1.2毫伏和0.7毫伏。当仅评估胰岛素依赖型患者时，发现神经传导变化程度较小。
