Background Diabetic neuropathy is common in diabetes mellitus. The early stage of diabetic neuropathy is often symptomless and difficult to be treated. The aim of this study was to assess the correlation between the ...Background Diabetic neuropathy is common in diabetes mellitus. The early stage of diabetic neuropathy is often symptomless and difficult to be treated. The aim of this study was to assess the correlation between the results of the sympathetic skin response (SSR) test and the development of diabetic neuropathy, and explore the use of SSR as an objective basis for the early diagnosis of diabetic neuropathy. Methods The latencies and amplitudes of initiation and of the N and P waves were determined by SSR testing of the extremities of 80 diabetic patients and 30 healthy controls. Results The latencies of initiation and of the N and P waves were significantly (P<0.001) longer in diabetic patients than in the controls, while there was no significant difference in the amplitudes (P>0.05). All but two patients (97.5%) demonstrated abnormal SSR in at least one limb. Conclusions SSR can detect early dysfunction of the small sympathetic fibers in people affected by diabetes mellitus, and may be a useful electrophysiological test for the early diagnosis of diabetic neuropathy.展开更多
目的研究交感神经皮肤反应(SSR)在2型糖尿病(T2DM)周围神经病变中的诊断价值,分析其与中医证候之间的关系。方法检测192例T2DM患者的SSR;按气虚、阴虚、阳虚、血瘀、痰湿进行中医证候归类,用5级记分法进行量化评分。结果SSR总体异常率为...目的研究交感神经皮肤反应(SSR)在2型糖尿病(T2DM)周围神经病变中的诊断价值,分析其与中医证候之间的关系。方法检测192例T2DM患者的SSR;按气虚、阴虚、阳虚、血瘀、痰湿进行中医证候归类,用5级记分法进行量化评分。结果SSR总体异常率为73.4%(141/192);在无周围神经损害症状和自主神经功能损害症状的患者中,SSR异常率分别为71.5%(27/38)和68.8%(11/16);性别、年龄、病程及有无自主神经功能损害症状对SSR异常率无影响(P均>0.05)。SSR上肢波幅(Amp)与脂蛋白B(ApoB)、低密度脂蛋白胆固醇(LDL-C)和胆固醇(CHO)呈正相关;下肢潜伏期(Lat)与餐后2 h血糖(2 h PBG)、舒张压(DBP)均呈正相关;下肢Amp与ApoA1、ApoB、LDL-C和CHO呈正相关(P<0.05或P<0.01)。阴虚证、血瘀证出现频率>50%;>60岁组阳虚证比例及积分均显著高于≤60岁组(P<0.05和P<0.01);病程长者血瘀证、阳虚证积分均显著增高(P均<0.01);有自主神经功能损害症状患者的气虚证和阴虚证积分均显著高于无自主神经功能损害症状者(P均<0.01);SSR异常组的阴虚证积分显著低于正常组(P<0.05)。相关分析显示:SSR的四肢Lat与气虚证积分呈负相关(0.316<r值<0.157,P<0.05或P<0.01);右上肢Amp与阳虚证、血瘀证积分均呈负相关(阳虚证r=0.207,P=0.006;血瘀证r=0.162,P=0.032)。结论SSR有助于发现糖尿病的亚临床神经病变,可作为评价T2DM患者早期自主神经及小纤维神经病变的敏感指标;血糖、血脂和血压可影响SSR参数。DPN患者阳虚、血瘀程度随病程延长和年龄增长渐进加重,气虚、阳虚和血瘀3种证候的病情程度对SSR参数的异常有一定影响。展开更多
文摘Background Diabetic neuropathy is common in diabetes mellitus. The early stage of diabetic neuropathy is often symptomless and difficult to be treated. The aim of this study was to assess the correlation between the results of the sympathetic skin response (SSR) test and the development of diabetic neuropathy, and explore the use of SSR as an objective basis for the early diagnosis of diabetic neuropathy. Methods The latencies and amplitudes of initiation and of the N and P waves were determined by SSR testing of the extremities of 80 diabetic patients and 30 healthy controls. Results The latencies of initiation and of the N and P waves were significantly (P<0.001) longer in diabetic patients than in the controls, while there was no significant difference in the amplitudes (P>0.05). All but two patients (97.5%) demonstrated abnormal SSR in at least one limb. Conclusions SSR can detect early dysfunction of the small sympathetic fibers in people affected by diabetes mellitus, and may be a useful electrophysiological test for the early diagnosis of diabetic neuropathy.
文摘目的研究交感神经皮肤反应(SSR)在2型糖尿病(T2DM)周围神经病变中的诊断价值,分析其与中医证候之间的关系。方法检测192例T2DM患者的SSR;按气虚、阴虚、阳虚、血瘀、痰湿进行中医证候归类,用5级记分法进行量化评分。结果SSR总体异常率为73.4%(141/192);在无周围神经损害症状和自主神经功能损害症状的患者中,SSR异常率分别为71.5%(27/38)和68.8%(11/16);性别、年龄、病程及有无自主神经功能损害症状对SSR异常率无影响(P均>0.05)。SSR上肢波幅(Amp)与脂蛋白B(ApoB)、低密度脂蛋白胆固醇(LDL-C)和胆固醇(CHO)呈正相关;下肢潜伏期(Lat)与餐后2 h血糖(2 h PBG)、舒张压(DBP)均呈正相关;下肢Amp与ApoA1、ApoB、LDL-C和CHO呈正相关(P<0.05或P<0.01)。阴虚证、血瘀证出现频率>50%;>60岁组阳虚证比例及积分均显著高于≤60岁组(P<0.05和P<0.01);病程长者血瘀证、阳虚证积分均显著增高(P均<0.01);有自主神经功能损害症状患者的气虚证和阴虚证积分均显著高于无自主神经功能损害症状者(P均<0.01);SSR异常组的阴虚证积分显著低于正常组(P<0.05)。相关分析显示:SSR的四肢Lat与气虚证积分呈负相关(0.316<r值<0.157,P<0.05或P<0.01);右上肢Amp与阳虚证、血瘀证积分均呈负相关(阳虚证r=0.207,P=0.006;血瘀证r=0.162,P=0.032)。结论SSR有助于发现糖尿病的亚临床神经病变,可作为评价T2DM患者早期自主神经及小纤维神经病变的敏感指标;血糖、血脂和血压可影响SSR参数。DPN患者阳虚、血瘀程度随病程延长和年龄增长渐进加重,气虚、阳虚和血瘀3种证候的病情程度对SSR参数的异常有一定影响。
文摘目的探讨酒依赖患者的自主神经功能状况及电生理特性,为临床诊治和防止复饮提供帮助。方法对酒依赖患者和健康对照者各61例行24 h动态心电图及交感神经皮肤反应(SSR)检测,分析心率变异性(HRV)全部正常窦性心搏间期的标准差(SDNN)、全程每5 min NN间期平均值的标准差(SDANN)、全部相邻RR间期之差的均方根值(RMSSD)、相邻NN间期之差>50 ms的个数占总的NN间期个数的百分比(PNN50)时域指标和SSR反应波潜伏期、波幅。结果酒依赖组HRV时域指标SDNN、SDANN、RMSSD、PNN50均较对照组降低,SSR反应波潜伏期延长,波幅降低,差异有统计学意义(P<0.01)。结论酒依赖(AD)患者长期酒精滥用导致自主神经功能改变,表现为自主神经总体功能减弱,交感及迷走神经张力降低,两者之间的平衡调制能力受损。临床AD的治疗和复饮防治中应加强自主神经功能的检测,在改善其他症状的同时应注重自主神经症状的缓解。
