Bertelsmann F W, Heimans J J, Van Rooy J C, Dankmeijer H F, Visser S L, Van der Veen E A
Department of Neurology, Free University Hospital, Amsterdam, The Netherlands.
J Neurol Neurosurg Psychiatry. 1987 Oct;50(10):1337-41. doi: 10.1136/jnnp.50.10.1337.
In order to study the effects of improved metabolic control on painful diabetic polyneuropathy, 15 patients were treated with continuous subcutaneous insulin infusion over a 12 month period. Polyneuropathy was assessed by pain score, neurological examinations, nerve conduction studies and determination of sensory thresholds and cardiovascular reflexes. Improved metabolic control was confirmed by significantly improved levels of glycosylated haemoglobin (11.7 +/- 0.3% at entry to the study, to 8.7 +/- 0.3% after 12 months; mean +/- SEM). Symptomatic relief was confirmed by significantly improved pain scores. Thresholds for thermal cutaneous sensation improved significantly from 6.0 +/- 0.8 degrees C at entry to the study to 2.7 +/- 0.7 degrees C after 12 months (mean +/- SEM). These findings suggest a selective improvement of peripheral small nerve fibre function after continuous subcutaneous insulin infusion. The importance of quantitating thermal cutaneous sensation in longitudinal studies of patients with diabetic neuropathy was confirmed.
为了研究改善代谢控制对疼痛性糖尿病多发性神经病变的影响，15例患者在12个月期间接受持续皮下胰岛素输注治疗。通过疼痛评分、神经学检查、神经传导研究以及感觉阈值和心血管反射的测定来评估多发性神经病变。糖化血红蛋白水平显著改善证实了代谢控制得到改善（研究开始时为11.7±0.3%，12个月后为8.7±0.3%；平均值±标准误）。疼痛评分显著改善证实了症状缓解。热皮肤感觉阈值从研究开始时的6.0±0.8℃显著改善至12个月后的2.7±0.7℃（平均值±标准误）。这些发现提示持续皮下胰岛素输注后外周小神经纤维功能有选择性改善。证实了在糖尿病神经病变患者的纵向研究中量化热皮肤感觉的重要性。
