Takahashi M, Nozaki S, Nakamura Y, Imaoka H, Kono N, Tarui S
Second Department of Internal Medicine, Osaka University Medical School, Japan.
Diabetes Res Clin Pract. 1988 Feb 19;4(3):191-6. doi: 10.1016/s0168-8227(88)80017-2.
We studied the effect of ischemia on the excitability of the sensory fibers of the median nerve in 43 patients with non-insulin-dependent diabetes mellitus (NIDDM) by a double stimulation method. Ischemia caused significantly less reduction of nerve excitability in patients with poor glycemic control and in patients diseased for 5 years or longer than in the normal control group. Hyperexcitability after ischemia was markedly greater than normal among short-term, poorly controlled diabetics, and markedly less pronounced among long-term, poorly controlled diabetics. In many diabetic patients with normal conduction velocity or without sensory disturbance, post-ischemic hyperexcitability was remarkable. A study of nerve excitability may be useful as one means of detecting early-stage disturbance of the diabetic peripheral nerve.
我们采用双刺激法研究了43例非胰岛素依赖型糖尿病（NIDDM）患者局部缺血对正中神经感觉纤维兴奋性的影响。与正常对照组相比，血糖控制不佳的患者以及患病5年及以上的患者，局部缺血导致的神经兴奋性降低明显较少。短期、血糖控制不佳的糖尿病患者缺血后的兴奋性明显高于正常水平，而长期、血糖控制不佳的糖尿病患者中这种情况则明显不那么显著。在许多传导速度正常或无感觉障碍的糖尿病患者中，缺血后兴奋性增强显著。研究神经兴奋性可能作为检测糖尿病周围神经早期病变的一种手段。
