Kasthuri A S, Sofat S, Kumar N
Commandant, 158 Base Hospital, C/o 56 APO.
Graded Specialist (Medicine), Command Hospital (CC), Lucknow 226 002.
Med J Armed Forces India. 2000 Jan;56(1):33-36. doi: 10.1016/S0377-1237(17)30087-4. Epub 2017 Jun 8.
One hundred patients of Diabetes Mellitus (70 with and 30 without clinical somatic neuropathy) were studied to correlate clinical severity with the magnitude of nerve conduction abnormalities. Age range was 10-79 years (mean 49) with equal number of males and females. Incidence of neuropathy was more in patients over 40 years of age (60 out of 70 patients) with duration of disease over two years (78.33%). The grades of severity were mild in 22 (31.33%), moderate in 25 (35.71%) and severe in 23 (32.86%) patients. Nerve conduction studies were carried out in 48 (27 with and 21 without clinical neuropathy) patients, using the apparatus Dantec (Cantata TM). The nerves (median, peroneal and sural) were stimulated at two points and the recording of latency; amplitude (micro V) and motor and sensory nerve conduction velocities (m/s) were done under identical environmental conditions. Sensory nerve conduction velocity was more affected than motor velocity. In the 21 patients without clinical neuropathy, 14 showed abnormalities indicating early involvement of peripheral nerves. Reduction of motor nerve conduction velocity was more in patients with moderate and severe grades. The reduction was more in lower than in upper limbs. Nerve conduction abnormality helps in diagnosis in diabetic neuropathy even in preclinical state and correlates with severity, in clinical neuropathy.
对100例糖尿病患者(70例有临床躯体神经病变,30例无临床躯体神经病变)进行了研究,以关联临床严重程度与神经传导异常的程度。年龄范围为10 - 79岁(平均49岁),男女数量相等。40岁以上患者(70例患者中的60例)且病程超过两年(78.33%)的神经病变发生率更高。22例(31.33%)患者为轻度严重程度,25例(35.71%)为中度,23例(32.86%)为重度。使用丹泰克(Cantata TM)仪器对48例患者(27例有临床神经病变,21例无临床神经病变)进行了神经传导研究。在两点刺激神经(正中神经、腓总神经和腓肠神经),并在相同环境条件下记录潜伏期、振幅(微伏)以及运动和感觉神经传导速度(米/秒)。感觉神经传导速度比运动速度受影响更大。在21例无临床神经病变患者中,14例显示异常,表明周围神经早期受累。中度和重度患者运动神经传导速度降低更明显。下肢的降低比上肢更明显。神经传导异常即使在临床前期状态下也有助于糖尿病神经病变的诊断,并且在临床神经病变中与严重程度相关。