Roberts H J
South Med J. 1982 Apr;75(4):411-6. doi: 10.1097/00007611-198204000-00009.
A 14-year experience with timed repetitive ankle jerk (TRAJ) testing provides fundamental insights into diabetic neuropathy (DN), both its diagnosis and treatment. Advantages of TRAJ include ease of performance, relative economy of the equipment, reproducibility of results, and a parameter that encompasses the entire reflex arc. Euthyroid patients with features suggesting DN often have prolongation of ankle jerk responses on one or both sides only after repetitive stimulation. Prolongation of TRAJ responses were elicited from 41% of overt diabetics and from 27% and 30% of patients with decreased glucose tolerance demonstrated by morning or afternoon testing, respectively. This characteristic response appears to reflect altered neuromuscular function in DN and was not encountered in patients with myasthenia gravis or thyroid dysfunction in the absence of concomitant glucose metabolic aberrations.
一项为期14年的定时重复性踝反射（TRAJ）测试经验为糖尿病神经病变（DN）的诊断和治疗提供了基本见解。TRAJ的优点包括操作简便、设备相对经济、结果可重复性以及一个涵盖整个反射弧的参数。具有DN特征的甲状腺功能正常患者通常仅在重复刺激后一侧或双侧的踝反射反应延长。41%的显性糖尿病患者以及分别通过上午或下午测试显示糖耐量降低的患者中，有27%和30%出现TRAJ反应延长。这种特征性反应似乎反映了DN中神经肌肉功能的改变，在没有伴随糖代谢异常的重症肌无力或甲状腺功能障碍患者中未出现。
