交感皮肤反应在糖尿病周围神经病变诊断中的应用

Sympathetic Skin Response in Diagnosis of Diabetic Peripheral Neuropathy

糖尿病周围神经病变(Diabetic Peripheral Neuropathy,DPN)是糖尿病最常见的并发症之一。由于目前DPN发病机制不清楚、治疗效果不理想,故早诊断、早治疗显得至关重要。有研究指出交感神经皮肤反应(Sympathetic Skin Response,SSR)可作为评价2型糖尿病患者早期周围植物神经功能状态的指标。本文对SSR应用于DPN临床诊断中的检测技术、观测参数进行综述,发现多数研究中指出,在临床应用中SSR波形、波幅以及潜伏期指标的异常率常受到多种因素的影响、会发生很大波动,而电位曲线下面积减少值相对稳定。据此笔者建议在DPN早期临床诊断中以SSR电位曲线下面积减少作为关键参数,辅助参考SSR波形、波幅以及潜伏期指标进行诊断。

Diabetic peripheral neuropathy （DPN） is one of the main complications of diabetic. However, the pathogenesis of DPN is still unknown and its treatment outcome is disappointing. Thus, early diagnosis and early treatment of DPN are significantly important. Some studies reported that sympathetic skin response （SSR） can be used as an indicator of early vegetative nerve function of type 2 diabetic patients. The present paper reviewed the previous studies on detecting techniques and observational parameters of SSR in diagnosis of DPN. And we found that most studies showed waveform, amplitude, and incubation period of SSR were disturb by many causes and changed very often, however, reduction values of potential area under the curve was relatively stable. Thus, we suggest reduction values of potential area under the curve should be used as a main parameter in the diagnosis of early DPN in clinic, and wavefoma, amplitude, and incubation period of SSR can be used as assistant parameter.