交感神经皮肤反应在2型糖尿病合并脑卒中自主神经病变中的价值

Clinical identification of sympathetic skin responses in type 2 diabetic mellitus combined with cerebral infarction autonomic nerve dysfunction

目的 探讨交感神经皮肤反应（SSR）检测在评价2型糖尿病合并脑卒中患者自主神经损害中的价值.方法 对100例2型糖尿病合并脑卒中患者进行SSR检测,另选取50例脑卒中患者和40例糖尿病患者作为对照.结果 糖尿病合并脑卒中组平均起始潜伏期（1.76±1.49）s,平均波幅（1.45±0.81）mV;脑卒中组分别为（1.46±1.26）s、（2.29±0.41）mV;糖尿病组分别为（1.48±1.29）s、（2.32±0.44）mV.糖尿病合并脑卒中组与后两组SSR的潜伏期、波幅比较差异有统计学意义（P＜0.01）.70%的脑卒中患者和60%的糖尿病患者可引出SSR,而糖尿病合并脑卒中患者仅15%可正常引出SSR,85%患者至少有一侧肢体SSR异常,表现为潜伏期延长、波幅降低、甚至波形消失,且下肢异常率高于上肢（P＜0.05）.结论 SSR可作为评价糖尿病合并脑卒中患者自主神经功能的一项简便易行、安全无创的客观检查方法.

Objective To investigate the significance of sympathetic skin response （SSR） to automatic dysfunction in patients with type 2 diabetes mellitus （T2DM） combined with cerebral infarction. Methods SSR was carried out in 100 patients with T2DM combined with cerebral infarction and 50 patients with cerebral infarction and 40 patients with diabetes were enrolled as control groups. Results There was significant difference of latencies and amplitudes of SSR between three groups （P 〈0.01）. SSR was elicited clearly in 70 percent cerebral infarction and 60 percent diabetes controls, but SSR was elicited clearly in only 15 patients with T2DM combined with cerebral infarction. 85 patients had abnormal responses in SSR in at least one limb, and showed prolongation of latency and remarkable decreases in amplitude. Conclusions SSR is an objective diagnostic method to assess the autonomic nerve dysfunction related to T2DM combined with cerebral infarction.