感觉神经和交感神经功能联合测定在痛性糖尿病周围神经病诊断中的价值  

THE SIGNIFICANCE OF JOINT ASSAY ON PERIPHERAL SENSORY AND SYMPATHETIC NERVE FUNCTION IN THE DIAGNOSIS OF PAINFUL DIABETIC NEUROPATHY

作　　者：王晓丹[1] 冯艺[1] 

机构地区：[1]北京大学人民医院麻醉科,北京100044

出　　处：《中国疼痛医学杂志》2010年第3期148-151,154,共5页Chinese Journal of Pain Medicine

摘　　要：目的:探讨定量感觉测定(QST)、交感皮肤反应(SSR)对糖尿病周围神经病(DPN)及痛性糖尿病周围神经病(PDN)的诊断意义。方法:连续收集211例2型糖尿病患者和30例健康对照者的总症状评分(TSS)、QST及SSR,分析感觉神经和交感神经功能变化与症状的相关性以及QST、SSR诊断PDN的灵敏性和特异性。结果:NIDDM患者QST结果明显异于正常人,症状轻微时疼痛程度与下肢Aα类神经病变程度相关。NIDDM患者SSR结果明显异于正常人;症状轻微较无症状患者以及症状明显较症状轻微患者上肢Lat、LatN、LatP明显延长,症状明显较无症状患者上下肢Lat、LatN、LatP均明显延长,PPAmp均明显减低;症状轻微时疼痛程度与上肢Lat、LatN、LatP、下肢LatP的延长和上肢PPAmp的减低有关。单独QST、单独SSR及二者联合检测PDN的灵敏度分别为74.42%、79.07%和85.71%,特异度分别为49.4%、35.42%和56.41%。结论:DPN无症状的早期,QST和SSR诊断的敏感度均较高;但出现症状后尤其是症状较重时,其诊断优势不明显;二者联合检测有助于PDN早期发现。Objective： To investigate the diagnosis significance of changes of peripheral sensory and sympathetic nerve function in diabetic peripheral neuropathy（DPN） and painful diabetic neuropathy（PDN）.Methods： Total Symptom Scores（TSS）,quantative sensory test（QST） and sympathetic skin response（SSR） of 211 diabetes patients and 30 volunteers were collected.Results： The mean QST and SSR outcomes were significantly higher than those of normal population,while the intensities of pain correlated with Aα nerve of lower limbs in patients with mild symptom,with significant prolongation of latency（Lat）,latency of N wave and P wave（LatN,LatP）of lower limbs than upper limbs.The sensitivity of QST,SSR and QST with SSR were 74.42%,79.07%,85.71%.The specificity the index above are 49.4%,35.42%,56.41%.Conclusion： The combination of QST and SSR helps detection of early PDN.

关 键 词：症状评分 电生理检测 2型糖尿病 痛性糖尿病神经病 

分 类 号：R587.2[医药卫生—内分泌]