AUTONOMIC AND SOMATIC PERIPHERAL-NERVE FUNCTION AND THE CORRELATION WITH NEUROPATHIC PAIN IN DIABETIC-PATIENTS
AUTONOMIC AND SOMATIC PERIPHERAL-NERVE FUNCTION AND THE CORRELATION WITH NEUROPATHIC PAIN IN DIABETIC-PATIENTS
复制标题
DOI：
10.1016/0022-510x(89)90239-6
复制
发表时间：
1989-12-01
影响因子：
4.4
通讯作者：
VANDERVEEN, EA
中科院分区：
文献类型：
--
作者：
LANTING, P;FAES, TJC;VANDERVEEN, EA
对25例糖尿病伴痛性神经病变和25例无痛性神经病变的糖尿病患者进行了瞳孔和心血管自主神经功能检查。在年龄、糖尿病持续时间或血糖控制方面，两组之间没有显著差异。振动知觉，反映外周大纤维功能，更严重的干扰症状组（P = 0.003）。反映躯体小纤维功能的热辨别阈值（TDTs）在所有有症状的患者中均异常，并且有症状和无症状患者之间的差异比大纤维功能更显著（P < 0.0001）。瞳孔收缩反应（副交感神经功能）的潜伏期延长17例有症状的患者和6例无疼痛;它被证明是显着延长疼痛性神经病变组（P = 0.001）。29例患者存在心血管自主神经病变，尤其是疼痛性神经病变患者（疼痛性神经病变组22例，无疼痛组7例）。TDT结果与瞳孔和心血管自主功能测试结果之间存在显著相关性（kappa系数分别为0.63和0.56，P < 0.0001）。我们的结论是，自主神经功能障碍往往存在于疼痛性神经病变的患者。然而，与心血管和瞳孔自主神经功能障碍相比，热感觉功能障碍与症状的存在更相关。
Pupillary and cardiovascular autonomic functions were examined in 25 diabetic patients with and 25 diabetic patients without painful neuropathy. There were no significant differences between the groups with regard to age, duration of diabetes or glycaemic control. Vibratory perception, reflecting peripheral large fibre function, was more severely disturbed in the symptomatic group (P = 0.003). Thermal discrimination thresholds (TDTs), reflecting somatic small fibre function, were abnormal in all symptomatic patients and the difference between patients with and without symptoms was more pronounced (P < 0.0001), than for large fibre function. The latency of the constriction reaction of the pupil (parasympathetic function) was prolonged in 17 symptomatic patients and in 6 patients without pain; it proved to be significantly more prolonged in the group with painful neuropathy (P = 0.001). Cardiovascular autonomic neuropathy was present in 29 patients, especially in patients with painful neuropathy (22 in the group with painful neuropathy, 7 in the group without pain). There was a significant correlation between results of TDT and respectively pupillary and cardiovascular autonomic function tests (kappa coefficient: 0.63 and 0.56, respectively, P < 0.0001). We conclude that autonomic dysfunction is often present in patients with painful neuropathy. However, thermal sensory dysfunction is better correlated with presence of symptoms than cardiovascular and pupillary autonomic dysfunction.