Boulton A J
Royal Infirmary, University of Manchester, England.
Can J Neurol Sci. 1994 Nov;21(4):S18-22; discussion S23-5. doi: 10.1017/s0317167100040701.
Diabetic polyneuropathy is a major complication of diabetes mellitus that frequently leads to foot ulceration. Because of economic impact of foot ulceration and subsequent amputation, major initiatives are under way in the United States and the United Kingdom to reduce their incidence by up to 50%. Although diabetic ulcers may have an ischemic and neuropathic component, the majority are neuropathic. Results from studies have shown a strong association between the neuropathy and the subsequent development of foot ulcers. However, other predisposing factors such as high foot pressures, inappropriate footwear, and other extrinsic pressure usually must be present, together with neuropathy, to cause foot ulcers. Therefore, the challenge to the physician is to identify the patient at risk and intervene so as to educate and prevent the occurrence of foot ulcers.
糖尿病性多发性神经病变是糖尿病的一种主要并发症，常导致足部溃疡。由于足部溃疡及其后续截肢带来的经济影响，美国和英国正在开展重大行动，以将其发病率降低多达50%。尽管糖尿病溃疡可能有缺血性和神经病变性成分，但大多数是神经病变性的。研究结果表明，神经病变与足部溃疡的后续发生之间存在密切关联。然而，通常还必须存在其他诱发因素，如高足压、不合适的鞋类以及其他外部压力，再加上神经病变，才会导致足部溃疡。因此，医生面临的挑战是识别有风险的患者并进行干预，以便开展教育并预防足部溃疡的发生。
