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[糖尿病性多发性神经病。II. 多发性神经病、血管病与神经传导速度]

[The diabetic polyneuropathy. II. Polyneuropathy, angiopathy and nerve conduction velocity].

作者信息

Fischer W, Reichel G, Rabending G, Bruns W, Haubenreiser H, Sodemann K, Zander G

出版信息

Endokrinologie. 1979;74(2):221-32.

PMID:535579
Abstract

789 patients with diabetes mellitus were studied by clinical and electroneurographical examination. Motor conduction velocity of the median and the tibial nerve and sensory conduction of the median nerve were determined. 81.1% of the patients we suffering from diabetes which began in childhood or adolescence, 13.9% were suffering from maturity onset diabetes. Average duration of the disease was 9.5 years, average age was 26.7 years. Clinical signs of polyneuropathy were found in 19.1%. Typical findings were pain and paraesthesia, lack or abolition of triceps surae reflexes, impaired pallaesthesia on lower extremities. 48.3% of 151 patients with clinical signs of polyneuropathy were suffering from combined angiopathy, 32.5% from microangiopathy, 7.9% from macroangiopathy. Severity of complicating retinopathy and macroangio,athy were found to be correlated with polyneuropathy. 58.2% of 323 diabetics with at least one delayed nerve conduction velocity exhibited signs of angiopathy. In nearly 30% of children and adolescents after comparatively short duration of the disease at least one conduction velocity was delayed. In diabetic children and adolescents metabolic disturbances are assumed to cause peripheral nerve dysfunction.

摘要

对789例糖尿病患者进行了临床和神经电生理检查。测定了正中神经和胫神经的运动传导速度以及正中神经的感觉传导速度。81.1%的患者患的是始于儿童期或青春期的糖尿病,13.9%的患者患的是成年型糖尿病。疾病平均病程为9.5年,平均年龄为26.7岁。19.1%的患者有多发性神经病变的临床体征。典型表现为疼痛和感觉异常、腓肠肌三头肌反射减弱或消失、下肢震动觉受损。151例有神经病变临床体征的患者中,48.3%合并血管病变,32.5%有微血管病变,7.9%有大血管病变。发现并发视网膜病变和大血管病变的严重程度与多发性神经病变相关。323例至少有一项神经传导速度延迟的糖尿病患者中,58.2%有血管病变体征。在近30%的儿童和青少年中,病程相对较短时就至少有一项传导速度延迟。在糖尿病儿童和青少年中,代谢紊乱被认为是导致周围神经功能障碍的原因。

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