痛性及非痛性糖尿病神经病变的临床研究进展

Clinical advances in painful and painless diabetic neuropathy

13%~35%的糖尿病患者存在痛性神经病变,而痛性及非痛性糖尿病神经病变(diabetic neuropathy,DNP)在糖尿病患者中差异性临床表现的原因尚不清楚。性别、糖尿病类型、糖化血红蛋白、血脂水平等对痛性DNP有一定预测作用,临床上需关注小纤维病变引起的疼痛和感觉异常;现有的诊断方法鉴别作用有限,痛性DNP诊断明确后需积极用药治疗。后续需进一步研究痛性DNP的发病机制,以寻找新的治疗靶点。

Painful neuropathy is present in 13%to 35%of diabetic patients,and the reasons for the differential clinical manifestations of painful and painless diabetic neuropathy(DNP)in diabetic patients are unclear.This review focuses on the latest clinical advances.It is observed that gender,diabetes type,glycosylated hemoglobin,and blood lipid levels have certain predictive effects on painful DNP.Clinical attention should be paid to pain and paresthesia caused by small fiber neuropathy.Existing diagnostic methods have limited differential effect,and active drug treatment is required after the diagnosis of painful DNP is confirmed.Further research on the pathogenesis of painful DNP is required in order to find new therapeutic target.