糖尿病神经病变中西医诊断思路

Diagnosis on Diabetic Neuropathy with Chinese and Western Medicine

糖尿病神经病变累及范围较广,临床表现复杂多样,故详细系统的问诊、体格检查及神经损伤相关的检查对于糖尿病神经病变的早期发现具有重要作用。其中神经传导速度是美国糖尿病协会规定的糖尿病神经病变确诊手段;定量感觉检查适合追踪随访患者病情。目前,皮肤活检是糖尿病神经病诊断的金标准,主要适用于小纤维神经病变。另外,MRI、角膜共聚焦显微镜检查等新科技诊断技术的介入,有助于提高DNP诊断的灵敏性和特异性。

The range of lesions involving the diabetic nerve is wide,complex and diverse clinical manifestations,so detailed interrogation,physical examination and nerve injury related examination plays an important role in early detection of diabetic neuropathy.The nerve conduction velocity is the provisions of the American Diabetes Association of diabetic neuropathy diagnosis; quantitative sensory tests for follow-up patients the condition. At present,the skin biopsy is the gold standard for the diagnosis of diabetic neuropathy,mainly applicable to small fiber neuropathy. In addition,MRI,corneal confocal microscopy and other new technology diagnosis technology involved,help to improve the DNP diagnostic sensitivity and specificity.