糖尿病周围神经病的高频超声与病理学的观察与对比研究  

The observed comparative study of high-frequency ultrasound and pathology of diabetic peripheral neuropathy

作　　者：张甲岩 吴珊[1] 何珊[1] 杨柳 

机构地区：[1]贵阳医学院附属医院神经内科,550004 [2]武汉市第三人民医院神经内科,430000

出　　处：《中华临床医师杂志（电子版）》2015年第4期80-83,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的通过对不同病程的糖尿病家兔坐骨神经进行超声与病理学观察,寻找糖尿病周围神经病声像学与组织病理学改变之间的关系。方法耳缘静脉注射STZ和四氧嘧啶的方法制作家兔糖尿病模型,分对照组(Ⅰ组),患糖尿病兔1个月组(Ⅱ组),患糖尿病兔3个月组(Ⅲ组)和患糖尿病兔6个月组(Ⅳ组),应用高频超声对各组家兔的坐骨神经于固定位置进行CSA测量,同时对各组家兔的坐骨神经行病理学的观察,分别行统计学分析,并进行对比观察。结果与对照组相比,糖尿病家兔坐骨神经多表现为CSA增粗,内部回声减低,边界模糊;实验组家兔在患病早期即发生明显的神经束膜变薄、脱髓鞘、神经纤维数量减少、轴突水肿变性、神经纤维直径增粗的情况。随着患病时间的延长上述变化越明显。结论糖尿病家兔坐骨神经神经纤维增粗、神经纤维之间排列疏松、轴索水肿是超声观察到神经增粗、内部回声减低和不均的病理基础。Objective To observe the sciatic nerve changes in different periods of diabetic rabbits by sonography and morphologic. To study the relationship between the ultrasound imaging and the morphology of peripheral nerves in diabetic rabbits. Methods STZ （100 mg/kg） and alloxan （50 mg/kg） were injected into the ear vein of the DM rabbit models. The cross-sectional areas （CSAs） of fixed position with the sciatic nerve of each diabetic group were measured by sonography;the middle parts of the sciatic nerve of each diabetic group were used for pathological examination by being observed under inverted phase contrast microscope. Results Compared with the control group, there was a significant increase in the CSAs of sciatic nerve in diabetic rabbits with decreased internal echo and fuzzy boundaries. And the longer the course of disease was, the more obvious such situation became. There was a statistical difference of the CSAs of the sciatic nerve in group Ⅳ （P〈0.05）. There was a significantly statistical difference （P〈0.01） in the pathological results of the sciatic nerve in diabetic rabbits. The changes were such as thining out of perineurium, demyelination and decrease of nerve fibers, edema and degeneration of axonal occured in the early stage of the disease, and it would be more obvious with the extension of the disease course. There was a significant diameter increase of single nerve fiber in diabetic rabbits with the loose arrangement of the nerve fibers. Such changes were more obvious as the course of the disease became longer. The diameter of the nerve fibers and the thickness of the perineurioma were markedly increased in diabetic groups compared with the control group （P〈0.05, respectively）. Conclusions CSAs of the sciatic nerve in each diabetic group became thicker, which had a positively correlation with the course of the disease. The loose arrangement and thickening of nerve fibers and axonal edema of diabetic rabbits＇ sciatic 〈br〉 nerve are the pathological basis of thicke

关 键 词：糖尿病 糖尿病神经病变 超声检查 病理学 临床 横截面积 

分 类 号：R587.2[医药卫生—内分泌]