糖尿病性神经病患者桡神经浅支中C纤维的反应特性

Responsive properties of C fibers of superficial branch of radial nerve in diabetic neuropathic patients.

目的 了解C纤维支配的感受单位 (C单位 )在糖尿病性神经病患者产生疼痛和感觉异常中的作用。 方法 用神经内微记录 (INMR)方法 ,观察糖尿病性神经病患者桡神经浅支中C单位的反应特性。 结果 糖尿病组的部分C单位具有自发放电 ,所有C单位的机械阈值明显降低 ,传导速度 (CV)显著减慢。它们对持续 1分钟的机械性阈刺激的反应同对照组相似 ,而在阈上机械性刺激期间放电频率明显增加 ,撤除阈刺激和阈上刺激后 ,后放电显著增多。在糖尿病组的C单位中三种亚单位的比例同对照组没有显著差异。

Objective To study the effect of C receptive unit innervated by C fiber (C unit) on diabetic neuropathic patients with pain and paresthesia. Methods Properties of C unit in superficial branch of radial nerve were observed on diabetic neuropathic patients, using intraneural microrecording(INMR) methods. Results It was found that some of the C units had spontaneously discharges, mechanical threshold and conduction velocity of C units were decreased significantly in diabetic group. The responses of C units in both diabetic and control group to one minute sustained mechanical threshold stimulus were similar,discharge frequencies during one minute sustained suprathreshold mechanical stimulus were significantly greater in the C unit of diabetic group. After the threshold and suprathreshold mechanical stimulus were removed, three was an obvious after discharges of C units in diabetic group. There was no significant difference in distribution of the three C subunits between diabetic and control group. Conclusions It was suggested that abnormally discharging of C units of diabetic group is a peripherat factor associated with pain and paresthesia of the patients.