Dyck P J, Karnes J L, Daube J, O'Brien P, Service F J
Brain. 1985 Dec;108 ( Pt 4):861-80. doi: 10.1093/brain/108.4.861.
Scored symptoms, neurological deficits, detection threshold of cutaneous sensation and parameters of nerve conduction were compared with quantitated neuropathological abnormalities in the sural nerve in 47 healthy subjects and 36 diabetic patients, 32 with and 4 without neuropathy. The fifth percentile line of a new Index of Pathology, which combines loss of myelinated fibres and abnormality of the remaining fibres, was found to provide a sensitive and reliable minimum neuropathological criterion for the diagnosis of polyneuropathy. Abnormality, as assessed by two clinical evaluations, similarly separated healthy subjects and diabetic patients into those with and without neuropathy. For the detection of diabetic polyneuropathy, vibration sense was more sensitive than touch-pressure or thermal cooling. Abnormalities of nerve conduction were found to be both sensitive and reliable in the detection of polyneuropathy. Velocity was most frequently abnormal, but only slightly more often than F wave latency and amplitude. We conclude that abnormality, as judged independently from two different types of evaluation, provides a sensitive and reliable minimal criterion for the diagnosis of neuropathy. Although symptoms, neurological deficits and abnormalities of nerve conduction are statistically associated, they should be evaluated separately to provide adequate characterization.
对47名健康受试者和36名糖尿病患者（其中32名有神经病变，4名无神经病变）的评分症状、神经功能缺损、皮肤感觉检测阈值和神经传导参数，与腓肠神经定量神经病理学异常进行了比较。一种新的病理学指数的第五百分位数线，该指数结合了有髓纤维的丧失和其余纤维的异常，被发现为多神经病变的诊断提供了一个敏感且可靠的最小神经病理学标准。通过两项临床评估所评估的异常情况，同样将健康受试者和糖尿病患者分为有神经病变和无神经病变两组。对于糖尿病性多神经病变的检测，振动觉比轻触觉或冷觉更敏感。发现神经传导异常在多神经病变的检测中既敏感又可靠。速度最常出现异常，但仅比F波潜伏期和波幅略频繁一些。我们得出结论，从两种不同类型的评估中独立判断的异常情况，为神经病变的诊断提供了一个敏感且可靠的最小标准。尽管症状、神经功能缺损和神经传导异常在统计学上相关，但它们应分别进行评估以提供充分的特征描述。
