使用SUDOSCAN评估高血压合并/不合并2型糖尿病患者的汗腺功能：一项电生理学研究。
Assessment of sudomotor function in hypertensive with/without type-2 diabetes patients using SUDOSCAN: An electrophysiological study.
作者信息
Hussein Ismail Ibrahim, Alshammary Safaa Hussein Ali, Al-Nimer Marwan S M
机构信息
Department of Physiology, College of Medicine, Al-Mustansiriya, University, Baghdad, Iraq.
Department of Pharmacology, College of Pharmacy, Hawler Medical University, Kurdistan Region, Erbil, Iraq.
出版信息
Clin Neurophysiol Pract. 2020 Dec 13;6:22-28. doi: 10.1016/j.cnp.2020.12.001. eCollection 2021.
OBJECTIVE
Electrochemical skin conductance (ESC) test is a simple and non-invasive screening test can detect dysfunction of the peripheral sudomotor, and indirectly estimates the function of cardiac autonomic nerves. This study aimed to assess the ESC values in hypertensive patients with/without type-2 diabetes by using SUDOSCAN technology. Moreover, this study evaluated the role of cardiometabolic risk factors on the results of ESC test.
METHODS
This cross-sectional study was carried on three groups of participants, including healthy subjects (Group I, n = 49), hypertensive without type-2 diabetes (Group II, n = 75) patients, and hypertensive with type-2 diabetes (Group III, n = 76) patients. Body mass index (BMI), blood pressure (systolic, diastolic and pulse pressure index), fasting serum glucose, and lipid profile were determined. ESC test as a measurement sudomotor function was determined by applying a small direct current at low voltage to hands and feet sensor plates through SUDOSCAN device.
RESULTS
ESC values of the peripheral sudomotor nerves in the Group II and III patients were significantly lower than the corresponding values of Group I. SUDOSCAN results of Group II and III. Significant discriminators of cardiac autonomic neuropathy (≥30 score) that determined by the area under the curve (AUC) with 95% confidence interval (95% C.I.) were, duration of the disease, BMI, and mean blood pressure in Group II, while the duration of the disease and the BMI were significant discriminators in Group III.
CONCLUSIONS
SUDOSCAN is a simple, useful device, which can detect the impairment of peripheral autonomic small nerve fibers and the risk of cardiac autonomic neuropathy in hypertension. Moreover, the duration of the disease and the associated cardiometabolic risk factors are important predictors of significant SUDOSCAN findings.
SIGNIFICANCE
ESC test is useful in detecting subclinical neuropathy in hypertensive patients as well as in type 2 diabetes.
目的
电化学皮肤电导（ESC）测试是一种简单且无创的筛查测试，可检测外周汗腺运动功能障碍，并间接评估心脏自主神经功能。本研究旨在使用SUDOSCAN技术评估2型糖尿病患者和非2型糖尿病患者的ESC值。此外，本研究评估了心脏代谢危险因素对ESC测试结果的作用。
方法
本横断面研究纳入了三组参与者，包括健康受试者（第一组，n = 49）、无2型糖尿病的高血压患者（第二组，n = 75）以及有2型糖尿病的高血压患者（第三组，n = 76）。测定了体重指数（BMI）、血压（收缩压、舒张压和脉压指数）、空腹血清葡萄糖和血脂谱。通过SUDOSCAN设备向手脚传感器板施加低电压直流电来测定作为汗腺运动功能测量指标的ESC测试。
结果
第二组和第三组患者外周汗腺运动神经的ESC值显著低于第一组的相应值。第二组和第三组的SUDOSCAN结果。通过曲线下面积（AUC）和95%置信区间（95% C.I.）确定的心脏自主神经病变（≥30分）的显著判别因素，在第二组中为疾病持续时间、BMI和平均血压，而在第三组中疾病持续时间和BMI是显著判别因素。
结论
SUDOSCAN是一种简单、有用的设备，可检测高血压患者外周自主小神经纤维的损伤和心脏自主神经病变的风险。此外，疾病持续时间和相关的心脏代谢危险因素是SUDOSCAN显著结果的重要预测因素。
意义
ESC测试有助于检测高血压患者以及2型糖尿病患者的亚临床神经病变。
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