Donaghue V M, Giurini J M, Rosenblum B I, Weissman P N, Veves A
Deaconess-Joslin Foot Center, Harvard Medical School, Boston, MA 02215, USA.
Diabetes Res Clin Pract. 1995 Jul;29(1):37-42. doi: 10.1016/0168-8227(95)01107-o.
We have examined the variability in function measurements of three sensory foot nerves in neuropathic diabetic patients and have compared them to measurements from healthy non-diabetic subjects. Sixty-six healthy, non-diabetic subjects (30 (45%) males, mean age 56 years (range, 21-84 years)) and 61 age and sex matched diabetic patients (33 (54%) males, mean age 55 years (range, 34-78 years) Type 1 diabetes mellitus (DM), mean duration of DM 24 years (range, 2-48 years)) were tested. Current perception threshold (CPT) at 250 Hz was employed to test the sensory function of three nerves: superficial peroneal, sural and posterior tibial. The vibration perception threshold, (VPT) and the cutaneous perception threshold (CCPT) were also assessed at the great toe. According to the results of the neuropathy disability score (NDS), mild neuropathy was present in 8 (13%) patients, moderate in 33 (54%) and severe in 20 (33%). In both groups the CPT of the posterior tibial nerve was higher than the other two nerves (P < 0.0001) while no difference was found between the superficial peroneal and sural nerves (P = NS). CPT was different between the two feet at the superficial peroneal nerve in 39 (64%) diabetic patients and 34 (52%) controls (P = NS), at the sural nerve in 40 (65%) and 45 (68%) (P = NS), and at the posterior tibial in 36 (59%) and 33 (50%), respectively (P = NS). VPT was different by more than 10% at the great toes in 26 (43%) diabetic subjects and CCPT in 21 (34%). We conclude that although there is variation in sensory nerve function tests in diabetic patients this is similar to that noticed in healthy subjects. The great variability of all quantitative sensory testing indicates that more than one site should be tested.
我们研究了神经性糖尿病患者三条足部感觉神经功能测量的变异性，并将其与健康非糖尿病受试者的测量结果进行了比较。测试了66名健康非糖尿病受试者（30名（45%）男性，平均年龄56岁（范围21 - 84岁））和61名年龄及性别匹配的糖尿病患者（33名（54%）男性，平均年龄55岁（范围34 - 78岁），1型糖尿病（DM），DM平均病程24年（范围2 - 48年））。采用250Hz的电流感觉阈值（CPT）来测试三条神经的感觉功能：腓浅神经、腓肠神经和胫后神经。还在拇趾处评估了振动感觉阈值（VPT）和皮肤感觉阈值（CCPT）。根据神经病变残疾评分（NDS）结果，8名（13%）患者存在轻度神经病变，33名（54%）为中度，20名（33%）为重度。两组中，胫后神经的CPT均高于其他两条神经（P < 0.0001），而腓浅神经和腓肠神经之间未发现差异（P = 无显著性差异）。39名（64%）糖尿病患者和34名（52%）对照组中，腓浅神经两侧足部的CPT存在差异（P = 无显著性差异）；40名（65%）和45名（68%）患者中，腓肠神经两侧足部的CPT存在差异（P = 无显著性差异）；36名（59%）和33名（50%）患者中，胫后神经两侧足部的CPT存在差异（P = 无显著性差异）。26名（43%）糖尿病受试者拇趾处的VPT差异超过10%，21名（34%）患者的CCPT差异超过10%。我们得出结论，尽管糖尿病患者感觉神经功能测试存在变异性，但这与健康受试者中观察到的情况相似。所有定量感觉测试的高度变异性表明应测试多个部位。
