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SUDOSCAN在中国人群中筛查糖尿病周围神经病变的应用。

The Application of SUDOSCAN for Screening Diabetic Peripheral Neuropathy in Chinese Population.

作者信息

Jin Jiewen, Wang Weimin, Gu Tianwei, Chen Wei, Lu Jing, Bi Yan, Zhu Dalong

机构信息

Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School. No 321, Zhongshan Road, Nanjing, Jiangsu, 210008, China.

出版信息

Exp Clin Endocrinol Diabetes. 2018 Sep;126(8):472-477. doi: 10.1055/s-0043-116673. Epub 2017 Sep 11.

Abstract

PURPOSE

Diabetic peripheral neuropathies are the common chronic complications of diabetes, but the diagnosis is insensitive by physical examination in busy outpatients. Here we evaluated the performance of SUDOSCAN in screening diabetic peripheral neuropathies in Chinese type 2 diabetic patients.

METHODS

The study enrolled 180 patients for annually screening. All patients underwent neurological symptoms assessment, clinical examination, nerve conduction studies and cardiovascular autonomic reflex tests. SUDOSCAN was tested and evaluated with electrochemical skin conductance in hands and feet, asymmetry ratio in hands and feet and predicted cardiac neuropathy.

RESULTS

Patients enrolled had an average age of 56.1 years, 9.8 years of diabetic duration. Patients with diabetic sensorimotor polyneuropathy showed significantly lower electrochemical skin conductance in feet and higher asymmetry ratio in feet compared with those without. Sensitivity and specificity of asymmetry ratio in feet for diagnosing diabetic sensorimotor polyneuropathy were 88.2% and 46.9% and area under ROC curve was 0.713. Patients with cardiovascular autonomic neuropathy showed significantly lower electrochemical skin conductance in hands and feet, and higher asymmetry ratio in feet and predicted cardiac neuropathy compared with those without. Sensitivity and specificity of electrochemical skin conductance in feet in diagnosing cardiovascular autonomic neuropathy were 85.6% and 76.1% with an area under ROC curve of 0.859.

CONCLUSIONS

SUDOSCAN is a sensitive test to detect diabetic peripheral neuropathy in China and could be an effective screening tool in in busy outpatients and primary health care.

摘要

目的

糖尿病周围神经病变是糖尿病常见的慢性并发症,但在繁忙的门诊中,体格检查对其诊断并不敏感。在此,我们评估了SUDOSCAN在中国2型糖尿病患者中筛查糖尿病周围神经病变的性能。

方法

本研究纳入180例患者进行年度筛查。所有患者均接受神经症状评估、临床检查、神经传导研究和心血管自主神经反射测试。通过检测和评估SUDOSCAN的手足电化学皮肤电导、手足不对称率以及预测心脏神经病变情况。

结果

纳入患者的平均年龄为56.1岁,糖尿病病程为9.8年。与无糖尿病感觉运动性多发性神经病变的患者相比,患有该病变的患者足部电化学皮肤电导显著降低,足部不对称率更高。足部不对称率诊断糖尿病感觉运动性多发性神经病变的敏感性和特异性分别为88.2%和46.9%,ROC曲线下面积为0.713。与无心血管自主神经病变的患者相比,患有该病变的患者手足电化学皮肤电导显著降低,足部不对称率更高,且预测心脏神经病变情况。足部电化学皮肤电导诊断心血管自主神经病变的敏感性和特异性分别为85.6%和76.1%,ROC曲线下面积为0.859。

结论

SUDOSCAN是在中国检测糖尿病周围神经病变的一项敏感检测方法,在繁忙的门诊和基层医疗保健中可能是一种有效的筛查工具。

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