瞬目反射检测在发现糖尿病患者早期颅神经损害中的意义  

Blink reflex abnormalities for the discovery of cranial nerves in diabetic patients

作　　者：张磊[1] 孙太欣[2] 潘华[1] 

机构地区：[1]首都医科大学北京天坛医院神经内科辅助检查中心,北京100050 [2]首都医科大学电力教学医院神经内科

出　　处：《癫痫与神经电生理学杂志》2013年第1期18-20,共3页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨糖尿病患者三叉神经-脑干-面神经传导通路功能状况，为发现亚临床颅神经及中枢神经系统病变提供客观依据。方法：运用瞬目反射技术，分别检测无颅神经及脑干病变的糖尿病患者67例，其中伴周围神经病变的39例，不伴周围神经病变的28例，同时，检测年龄、性别相匹配的健康对照组36例。糖尿病患者记录其最近一周内的糖化血红蛋白及检查当日早餐前的空腹血糖。结果：糖尿病不伴周围神经病变组与伴周围神经病变组与正常对照组的R1潜伏期比较差异有显著意义，糖尿病两组间R1比较差异也有显著意义，R2潜伏期，R2、R3与RI潜伏期差值，三组间比较差异均无显著意义。R1潜伏期与糖尿病病程呈正相关，与糖化血红蛋白、空腹血糖无相关性。结论：选择R1潜伏期改变，提示无症状糖尿病患者存在三又神经-脑干-面神经传导通路亚临床病变。随糖尿病病程延长，这一通路受损进一步加重，还应防范因血脑屏障的破坏而出现中枢神经系统病变的可能。Objective：To explore, an objective basis for the discovery of subclinical cranial nerves and central nervous system lesions by detecting the functional status of the trigeminal nerve -brainstem - facial nerve pathway in diabetic patients. Methods： Sixty-seven diabetic patients without cranial nerves and brainstem lesions were divided into two groups in the study in cluding 39 cases with peripheral neu ropathy, and 28 cases with out peripheral neuropathy. 36 cases of age, sex-matched healthy control sub jects were also performed. In the blink reflex examination ipsilateral R1, R2 and contralateral R2 latency were recorded,and bilateral latency difference,the difference between R1 and ipsilateral R2, R1 ah2 -~n tralatera R2 were also detected. The fasting blood glucose of diabetic patients in the day of examination, and the glycosylated hemoglobin in last week were recorded. Results=R1 latency between diabetic groups with and without peripheral neuropathy and control group was significant. Two groups of diabetes were significant. But R2 latency,R2,R3 and R1 latency difference among three groups showed no significant difference. R1 latency was positively correlated with the duration of diabetes, but not relevant with ghycosylated hemoglobin and fasting blood glucose. Conclusion： R1 latency can be changed selectively, in asymptomatic diabetic patients there existe trigeminal nerve-brainstem-facial nerve pathway sub clinical lesions. The prolonged duration of diabetes, further increase the damage of this pathway. The central nervous system lesions should be prevented form destruction of blood-brain barrier.

关 键 词：瞬目反射(BR) 糖尿病 颅神经 中枢神经系统病变 

分 类 号：R587.1[医药卫生—内分泌]