Lindström P, Lindblom U, Brismar T
Department of Neurology, Karolinska Hospital, Stockholm, Sweden.
J Neurol Neurosurg Psychiatry. 1997 Sep;63(3):346-50. doi: 10.1136/jnnp.63.3.346.
To determine if the recovery of nerve function after ischaemic block is impaired in patients with diabetes mellitus relative to healthy controls.
Median nerve impulse conduction and vibratory thresholds in the same innervation territory were studied in patients with diabetes mellitus (n = 16) and age matched controls (n = 10) during and after 30 minutes of cuffing of the forearm.
Cuffing caused a 50% reduction of the compound nerve action potential (CNAP) after 21.9 (SEM 1.6) minutes in patients with diabetes mellitus and after 10.6 (0.7) minutes in controls. After release of the cuff the half life for CNAP recovery was 5.13 (0.45) minutes in patients with diabetes mellitus and <1 minute in controls. At seven minutes after release of the cuff CNAP was fully restored in the controls whereas in patients with diabetes mellitus CNAP had only reached 75.1 (4.1)% of its original amplitude. After onset of ischaemia it took 14.6 (1.9) minutes in patients with diabetes mellitus before the vibratory threshold was doubled, whereas this took 5.8 (0.8) minutes in controls. After release of the cuff half time for recovery of vibratory threshold was 8.8 (1.0) minutes in patients with diabetes mellitus and 2.6 (0.3) minutes in controls. Ten minutes after the cuff was released the threshold was still raised (2.0 (0.3)-fold) in the diabetes mellitus group, whereas it was normalised in controls. Among patients with diabetes mellitus the impaired recovery correlated with older age, higher HbA1c, and signs of neuropathy, but not with blood glucose.
After ischaemia there is a delayed recovery of nerve conduction and the vibratory sensibility in patients with diabetes mellitus. Impaired recovery after ischaemic insults may contribute to the high frequency of entrapment neuropathy in patients with diabetes mellitus.
确定与健康对照相比，糖尿病患者缺血性阻滞后神经功能的恢复是否受损。
对糖尿病患者（n = 16）和年龄匹配的对照者（n = 10）在前臂袖带绑扎30分钟期间及之后，研究同一神经支配区域的正中神经冲动传导和振动阈值。
在糖尿病患者中，袖带绑扎21.9（标准误1.6）分钟后复合神经动作电位（CNAP）降低50%，在对照者中为10.6（0.7）分钟后。松开袖带后，糖尿病患者CNAP恢复的半衰期为5.13（0.45）分钟，对照者<1分钟。松开袖带7分钟后，对照者的CNAP完全恢复，而糖尿病患者的CNAP仅达到其原始幅度的75.1（4.1）%。缺血开始后，糖尿病患者的振动阈值加倍需要14.6（1.9）分钟，而对照者需要5.8（0.8）分钟。松开袖带后，糖尿病患者振动阈值恢复的半衰期为8.8（1.0）分钟，对照者为2.6（0.3）分钟。松开袖带10分钟后，糖尿病组的阈值仍升高（2.0（0.3）倍），而对照者的阈值已恢复正常。在糖尿病患者中，恢复受损与年龄较大、糖化血红蛋白较高和神经病变体征相关，但与血糖无关。
糖尿病患者缺血后神经传导和振动感觉恢复延迟。缺血性损伤后恢复受损可能导致糖尿病患者卡压性神经病的高发。
