神经电生理检查在糖尿病前期周围神经病变的应用进展

Application of electrophysiological test in prediabetic peripheral neuropathy

糖尿病前期周围神经病的早期诊断重点依赖于对小纤维的评价.传统的神经传导检测只能反映大的有髓纤维的功能,而对于与痛觉及自主神经病变有关的小纤维病变缺乏敏感性.近年来随着神经电生理诊断技术的发展,糖尿病前期周围神经病的早期诊断不断提高.临床中常用小纤维病变的检测方法主要包括皮肤交感反应、定量感觉检查、接触性热痛诱发电位及定量催汗轴突反射等.就糖尿病前期周围神经病的发病机制、神经功能的病理学改变及神经电生理技术在糖尿病前期周围神经病变的应用进展加以综述,旨在为糖尿病前期周围神经病变的早期诊断提供客观依据.

Early diagnosis of prediabetic peripheral neuropathy depends on the evaluation of small fibers.Traditional nerve conduction tests can only evaluate the function of large myelinated fibers,while lack of sensitivity to small fibrous lesions.These lesions were related to pain and autonomic neuropathy.In recent years,with the progress of neurophysiological diagnosis technology,the early diagnosis of diabetic peripheral neuropathy has been improved.Clinical methods,commonly used in the detection of small fibrous lesions,mainly include skin sympathetic response,quantitative sensory test,contact heat pain evoked potential,and quantitative sudomotor axonal reflex test.In this paper,the pathogenesis of diabetic peripheral neuropathy,neurological pathological changes and applications of electrophysiology technology were reviewed to provide an objective basis for early diagnosis of prediabetic peripheral neuropathy.