Mayr N, Wimberger D, Mamoli B, Vierhapper H
Wien Klin Wochenschr. 1984 May 11;96(10):393-8.
In 26 type I diabetics ranging in age from 18 to 65 years with a duration of illness of between 1 and 34 years the following investigations were performed: 1. case history and questionnaire; 2. neurological examination; 3. determination of the vibration threshold; 4. electroneurography of the peroneal nerve and the sural nerve; 5. determination of the cardiovascular reflexes; 6. medical examination and additional findings; 7. ophthalmological investigation. 21 patients showed evidence of sensorimotor polyneuropathy (SM-PNP), the average age of this group (41 years) being 10 years higher than in the group without SM-PNP (31 years). The values of HbA1c were pathological in 17 of 21 cases with SM-PNP, and 2 of 5 cases without SM-PNP. Retinopathy was found rarely in both groups. 13 patients showed evidence of autonomic neuropathy (ANP). The mean duration of illness (15.4 years) and the average age of patients (36.5 years) in this group was distinctly higher than in the group without ANP (mean duration of illness: 8.9 years, mean age: 31.9 years). 12 patients with ANP and 7 patients without ANP had abnormally high HbA1c levels. Diabetic SM-PNP was most frequently (in 19 of 21 cases) diagnosed by electroneurographical investigation of the peroneal nerve. In the diagnosis of diabetic ANP the anamnesis (8 positive findings) and the determination of the heart rate variation during deep breathing (7 positive findings) are complementary. Among the 13 patients with ANP, 12 also had SM-PNP, whereas among the 21 patients with SM-PNP only 12 showed evidence of concomitant ANP.
对26例年龄在18至65岁之间、病程为1至34年的I型糖尿病患者进行了以下检查:1. 病史采集与问卷调查;2. 神经学检查;3. 振动阈值测定;4. 腓总神经和腓肠神经的神经电图检查;5. 心血管反射测定;6. 体格检查及其他检查结果;7. 眼科检查。21例患者有感觉运动性多发性神经病变(SM-PNP)证据,该组患者的平均年龄(41岁)比无SM-PNP组(31岁)高10岁。21例有SM-PNP的患者中17例糖化血红蛋白(HbA1c)值异常,5例无SM-PNP的患者中有2例异常。两组中视网膜病变均少见。13例患者有自主神经病变(ANP)证据。该组患者的平均病程(15.4年)和平均年龄(36.5岁)明显高于无ANP组(平均病程:8.9年,平均年龄:31.9岁)。12例有ANP的患者和7例无ANP的患者HbA1c水平异常升高。糖尿病性SM-PNP最常(21例中有19例)通过腓总神经的神经电图检查确诊。在糖尿病性ANP的诊断中,病史(8例阳性结果)和深呼吸时心率变异性测定(7例阳性结果)互为补充。13例有ANP的患者中,12例也有SM-PNP,而21例有SM-PNP的患者中只有12例有伴随ANP的证据。