糖尿病合并慢性炎性脱髓鞘性多发性神经根神经病研究进展  

Research progress of diabetes mellitus complicated with chronic inflammatory demyelinating polyneuropathy

作　　者：付秀娟[1] 卢祖能[1] FU Xiujuan;LU Zuneng(Department of Neurology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院神经内科,430060

出　　处：《天津医药》2024年第2期220-224,共5页Tianjin Medical Journal

摘　　要：近年来关于糖尿病(DM)患者合并慢性炎性脱髓鞘性多发性神经根神经病(CIDP)的流行病学研究结果存在较大差异,其相关性仍存在争议。尽管如此,由于CIDP在DM患者中发病率高且可治疗,因此准确诊断与鉴别DM-CIDP对于指导临床用药具有重要的价值。在临床表现方面,可通过发病年龄、病程、血糖控制水平以及主要症状特点等进行鉴别。在辅助检查方面,脑脊液蛋白水平、电生理检查的脱髓鞘表现以及神经影像学检查为常见鉴别诊断手段,神经病理检查和血清特异性抗体可为DM-CIDP的鉴别诊断提供新的支持依据。此外,对免疫调节和(或)免疫抑制疗法的良好反应支持DM-CIDP的诊断。通过临床表现、电生理特征、实验室检查、神经病理、影像学以及治疗反应等方面综合评估,可以提高DM-CIDP的鉴别诊断水平。In recent years,the results of epidemiological research findings on chronic inflammatory demyelinating polyneuropathy(CIDP)in patients with diabetes mellitus(DM)are quite different,and its correlation is still controversial.Nevertheless,due to the high incidence and treatability of CIDP in DM patients,accurate diagnosis and differentiation of DM-CIDP are of great value for guiding clinical drug use.In terms of clinical manifestations,it can be distinguished by age of onset,disease duration,blood glucose control level and main symptom characteristics.Supplementary diagnostic methods frequently involve evaluating cerebrospinal fluid protein levels,demyelination patterns in electrophysiological tests and neuroimaging studies.Additionally,neuropathological examination and specific serum antibodies can provide more diagnostic support for distinguishing DM-CIDP.Furthermore,a positive response to immunomodulatory and/or immunosuppressive therapies supports the diagnosis of DM-CIDP.By comprehensively evaluating clinical manifestations,electrophysiological characteristics,laboratory tests,neuropathology,imaging,and treatment responses,the accuracy of the differential diagnosis for DM-CIDP can be improved.

关 键 词：糖尿病 慢性炎性脱髓鞘性多发性神经病 研究进展 鉴别诊断 

分 类 号：R745[医药卫生—神经病学与精神病学] R741.04[医药卫生—临床医学]