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它们的临床相关性(作者译)

[Their clinical correlation (author's transl)].

作者信息

Ohnishi A, Inagaki K, Kuroiwa Y

出版信息

No To Shinkei. 1981 Mar;33(3):259-64.

PMID:7248113
Abstract

Morphometric studies of biopsied sural nerves were performed among 16 diabetic patients (14 with polyneuropathy and 2 without polyneuropathy). Main clinical findings at the time of biopsy were reviewed retrospectively and the correlations between clinical findings (the presence or absence of sensory disturbance, motor disturbance, retinopathy and pain, and the duration of sensory disturbance) and nerve fiber densities were analyzed. The following results and conclusions were obtained. 1) Decrease of densities of both myelinated and unmyelinated fibers was found in 9 out of 16 cases. Decrease of the density of unmyelinated fibers in diabetic patients was noticeable among over 100 cases of various neuropathies studied by us. Both myelinated and unmyelinated fibers seem to be decreased with the duration of sensory disturbance. 2) In teased fiber analysis myelinated fibers showing axonal degeneration as well as segmental demyelination were seen at relatively lower frequency. Onion bulb formation was found only in one case out of 16 cases. Therefore it was concluded that axonal degeneration is probably the main pathological change in sural nerves in this study, considering the decrease of nerve fiber densities as well. 3) The mean thickness of the perivascular space of endoneurial small vessels in diabetic patients was greater than that of the control (32 consecutive patients of various neuropathies). 4) No good correlations were found between the presence or absence of motor disturbance, pain and retinopathy, and the nerve fiber densities.

摘要

对16例糖尿病患者(14例患有多发性神经病,2例未患多发性神经病)的腓肠神经活检标本进行了形态计量学研究。回顾性分析了活检时的主要临床发现,并分析了临床发现(感觉障碍、运动障碍、视网膜病变和疼痛的有无以及感觉障碍的持续时间)与神经纤维密度之间的相关性。得出以下结果和结论。1)16例中有9例发现有髓纤维和无髓纤维密度均降低。在我们研究的100多例各种神经病患者中,糖尿病患者无髓纤维密度降低较为明显。有髓纤维和无髓纤维似乎都随着感觉障碍持续时间的延长而减少。2)在 teased纤维分析中,显示轴突变性以及节段性脱髓鞘的有髓纤维出现频率相对较低。16例中仅1例发现有洋葱球样结构形成。因此,考虑到神经纤维密度降低,得出结论:在本研究中,轴突变性可能是腓肠神经的主要病理变化。3)糖尿病患者神经内膜小血管周围间隙的平均厚度大于对照组(32例各种神经病的连续患者)。4)未发现运动障碍、疼痛和视网膜病变的有无与神经纤维密度之间存在良好的相关性。

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