神经电生理检查及尿流率测定在糖尿病神经病变早期诊断中的价值

EARLY DIAGNOSIS OF DIABETIC NEUROPATHY-AN EVALUATION OF NEUROPHYSIOLOGIC AND URODYNAMIC VARIATIONS

本文测定了78例Ⅱ型糖尿病患者的感觉神经传导速度(SCV)、诱发电位及尿流率,结果显示:(1)与正常对照相比,糖尿病患者胫后神经和腓肠神经的SCV明显减慢,并可见于部分无神经征象的患者;(2)视觉、听觉诱发电位的异常率分别为23.61％及26％,仅少数有相应的临床表现;(3)本组患者最大尿流率降低约30％,其中大多数无排尿障碍症状。表明上述检查有助于糖尿病周围神经病变、中枢神经病变及膀胱神经病变的早期诊断。部分患者在较好地控制血糖后,SCV及尿流率均有明显改善。

A total of 78 patients with NIDDM were enrolled in a prospective study of neurophysiologic and urodynamic variations which comprises 1) sensory conduction velocity (SCV) of posterior tibial and sural nerve; 2) visual evoked potentials (VEP); 3) brainstem auditory evoked potentials (BAEP); 4) maximum urine flow rate (MFR). The SCV of posterior tibial and sural nerves of the 78 patients were significantly slower than those of 39 age- and sex-matched controls. 30% patients showed low MFR including 2 with dysuria. The BAEP and VEP were abnormal in 26% and 23.6% patients respectively and most of them lacked central neurological symptoms and signs. It suggested that the measurement of above parameters was useful for the early diagnosis of diabetic peripheral neuropathy, diabetic neurogenic bladder and diabetic central nervous system damage. 15 diabetic patients associated with neuropathy got significant improvement of SCV after 11 months of dietary control and medication and 15 diabetic patients with reduced MFR also bad improvement after 9 months' treatment Jt is exciting for us to assume that the diabetic neuropathy could be reversible if diagnosis and proper treatment is in time.