患有神经性足部病变的糖尿病患者的定量汗液测试
Quantitative sweat test in diabetics with neuropathic foot lesions.
作者信息
Ahmed M E, Le Quesne P M
出版信息
J Neurol Neurosurg Psychiatry. 1986 Sep;49(9):1059-62. doi: 10.1136/jnnp.49.9.1059.
The volume of sweat produced by axon reflex stimulation using acetylcholine was measured in one foot each of 35 control subjects and 52 feet of 37 diabetic patients (28 with neuropathic ulceration, 11 with Charcot arthropathy, nine with somatic neuropathy but no foot lesion and four with no evidence of somatic neuropathy). In controls, the volume of sweat was greater in males than females. A flare response was seen in 94% of control feet. In diabetics, the volume of sweat was within the control range in 17 feet, increased in one, reduced in seven, and absent in 27. Sweating was absent in 75% of feet with a neuropathic ulcer; a flare response was absent in 86% of them. Sweating was only absent in 36% of feet with Charcot arthropathy and was increased in one, whereas the flare response was absent in all. Autonomic cardiovascular reflexes were more frequently abnormal than the sweat test; sweating was absent in only one patient with normal cardiovascular reflexes.
对35名对照受试者的每只脚以及37名糖尿病患者的52只脚（28例患有神经性溃疡，11例患有夏科氏关节病，9例患有躯体神经病变但无足部病变，4例无躯体神经病变迹象），测量了使用乙酰胆碱通过轴突反射刺激产生的汗液量。在对照受试者中，男性的汗液量多于女性。94%的对照足部出现了潮红反应。在糖尿病患者中，17只脚的汗液量在对照范围内，1只脚汗液量增加，7只脚汗液量减少，27只脚无汗液分泌。75%患有神经性溃疡的足部无汗液分泌；其中86%无潮红反应。仅36%患有夏科氏关节病的足部无汗液分泌，1只脚汗液量增加，而所有这些足部均无潮红反应。自主心血管反射比汗液测试更常出现异常；只有一名心血管反射正常的患者无汗液分泌。
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