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糖尿病青少年的视觉诱发电位:代谢控制的影响及其与周围神经病变的关系

Visual evoked potentials in diabetic teen-agers: influence of metabolic control and relationship with peripheral neuropathy.

作者信息

Comi G, Martinelli V, Galardi G, Medaglini S, Poggi A, Beccaria L, Meschi F, D'Arcais A F

机构信息

Department of Neurology, University of Milan, Medical School, Scientific Institute H.S. Raffaele, Italy.

出版信息

Metab Pediatr Syst Ophthalmol (1985). 1986;9(2-4):85-7.

PMID:3452014
Abstract

85 type 1 diabetics aged between 8 and 20 years (mean: 15.06) performed Pattern Reversal Visual Evoked Potentials (PRVEP). In addition all of them were investigated for peripheral neuropathy and 63 subjects for retinopathy. Our study disclosed a subclinical involvement of optic nerve pathways in about 1/4 of diabetic teen-agers. P100 mean latency was delayed in diabetics for both 30' (112.8 +/- 7.7 msec versus 109.1 +/- 4.8 msec) and 15' check size (119.1 +/- 10.5 msec versus 112.8 +/- 5.2 msec). The N75-N140 interpeak latency was also significantly delayed and the mean N75-P100 amplitude was significantly reduced in diabetics. No correlation was found between PRVEPs latency and age, HbA1, and insulin requirement. The mean P100 latency significantly increased with the duration of diabetes. A negative correlation was found at the 30' check size between P100 latency and motor and sensory conduction velocity in all the examined nerves. 10 out of 63 patients, who had been examined with fluorangiography, showed abnormalities; only 2 of these 10 subjects had abnormal PRVEP. The association of prolonged P100 latency, prolonged N75-N140 interpeak latency and reduced N75-P100 amplitude can be considered consequent to a desincronisation of the impulses travelling along the optic pathways.

摘要

85名年龄在8至20岁之间(平均年龄:15.06岁)的1型糖尿病患者进行了图形翻转视觉诱发电位(PRVEP)检测。此外,对所有患者均进行了周围神经病变检查,对63名患者进行了视网膜病变检查。我们的研究发现,约四分之一的糖尿病青少年存在视神经通路的亚临床受累情况。糖尿病患者在30'检查尺寸时P100平均潜伏期延迟(112.8±7.7毫秒对109.1±4.8毫秒),在15'检查尺寸时也延迟(119.1±10.5毫秒对112.8±5.2毫秒)。糖尿病患者的N75-N140峰间潜伏期也显著延迟,且平均N75-P100波幅显著降低。未发现PRVEP潜伏期与年龄、糖化血红蛋白(HbA1)及胰岛素需求量之间存在相关性。P100平均潜伏期随糖尿病病程显著增加。在30'检查尺寸时,发现P100潜伏期与所有检查神经的运动和感觉传导速度之间呈负相关。63名接受荧光血管造影检查的患者中有10名显示异常;这10名患者中只有2名PRVEP异常。P100潜伏期延长、N75-N140峰间潜伏期延长及N75-P100波幅降低的联合情况可被认为是沿视神经通路传播的冲动去同步化的结果。

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