皮肤交感反应与2型糖尿病自主神经病变相关性研究

Relevance between sympathetic skin response and autonomic neuropathy in type 2 diabetes mellitus

目的探讨皮肤交感反应(sympathetic skin response,SSR)对2型糖尿病自主神经病变的诊断价值。方法对111例2型糖尿病患者及30例健康体检者进行SSR及神经传导速度测定,检测糖化血红蛋白(hemoglobin A1c,HbAlc)等多项生化指标,同时分析与SSR异常有关的因素。结果与对照组比较,病例组SSR潜伏期延长,波幅降低(P<0.05)。与病程<5年组比较,5～10年组、病程≥10年组上肢SSR潜伏期延长(P<0.05),而波幅变化无统计学差异(P>0.05)。各不同病程组间SSR异常率比较无统计学差异(P>0.05)。周围神经病变组SSR异常率高于无周围神经病变组(P<0.05),自主神经症状的有无对SSR异常率无影响(P>0.05)。Logistic回归分析结果显示,HbAlc是2型糖尿病患者SSR异常的相关因素。结论 SSR可早期发现糖尿病患者自主神经功能损害,HbAlc是2型糖尿病患者SSR异常的相关因素。

Objective To evaluate the diagnostic value of sympathetic skin response （SSR） for autonomic neuropathy in type 2 diabetes mellitus. Methods SSR test and conventional nerve conduction velocity （NCV） test were examined in ill type 2 diabetic patients and 30 healthy controls. Hemoglobin Alc （HbAlc） and other biochemical indicators were detected among all the diabetic patients. Related factors of abnormal SSR were analyzed. Results Compared with the control group in SSR test, the latency of the case group extended and amplitude decreased （P〈0. 05）. Compared with the group of disease durationS5 years in SSR test, the arm latency of 5-10 years group and duration ;10 years group extended （P〈0.05）, but the amplitude was not significantly different （P〉0.05）. There was no significant difference among these three groups in abnormal rates of SSR. The abnormal rate of SSR was related with peripheral neuropathy （P〈0. 05）, but not with autonomic symptoms （P〉0.05）. Logistic regression analysis showed that HbAlc was a relevant factor of abnormal SSR in type 2 diabetic patients. Conclusions SSR can be used to detect the early dysfunction of autonomic nerves in type 2 diabetic patients. HbAlc is a relevant factor of abnormal SSR in type 2 diabetic patients.