CLINICAL AND NEUROPATHOLOGICAL CRITERIA FOR THE DIAGNOSIS AND STAGING OF DIABETIC POLYNEUROPATHY
CLINICAL AND NEUROPATHOLOGICAL CRITERIA FOR THE DIAGNOSIS AND STAGING OF DIABETIC POLYNEUROPATHY
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DOI：
10.1093/brain/108.4.861
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发表时间：
1985-12-01
期刊：
影响因子：
14.5
通讯作者：
SERVICE, FJ
中科院分区：
文献类型：
--
作者：
DYCK, PJ;KARNES, JL;SERVICE, FJ
评分症状，神经功能缺损，皮肤感觉的检测阈值和神经传导参数进行了比较，在腓肠神经的神经病理学异常定量47例健康受试者和36例糖尿病患者，32例和4例无神经病变。第五百分位数线的一个新的病理指数，其中结合了损失的有髓纤维和异常的其余纤维，被发现提供了一个敏感和可靠的最低神经病理学标准诊断多发性神经病。通过两项临床评价评估的异常，同样将健康受试者和糖尿病患者分为有神经病变和无神经病变。对于糖尿病多发性神经病的检测，振动感觉比触摸压力或热冷却更敏感。神经传导阻滞是诊断多发性神经病的敏感而可靠的方法。速度异常最常见，但仅略高于F波潜伏期和振幅。我们的结论是，异常，独立判断两种不同类型的评估，提供了一个敏感和可靠的最低标准神经病变的诊断。尽管症状、神经功能缺损和神经传导异常具有统计学相关性，但应分别进行评价，以提供充分的表征。
Scored symptoms, neurological deficits, detection threshold of cutaneous sensation and parameters of nerve conduction were compared with quantitated neuropathological abnormalities in the sural nerve in 47 healthy subjects and 36 diabetic patients, 32 with and 4 without neuropathy. The fifth percentile line of a new Index of Pathology, which combines loss of myelinated fibres and abnormality of the remaining fibres, was found to provide a sensitive and reliable minimum neuropathological criterion for the diagnosis of polyneuropathy. Abnormality, as assessed by two clinical evaluations, similarly separated healthy subjects and diabetic patients into those with and without neuropathy. For the detection of diabetic polyneuropathy, vibration sense was more sensitive than touch-pressure or thermal cooling. Abnormalities of nerve conduction were found to be both sensitive and reliable in the detection of polyneuropathy. Velocity was most frequently abnormal, but only slightly more often than F wave latency and amplitude. We conclude that abnormality, as judged independently from two different types of evaluation, provides a sensitive and reliable minimal criterion for the diagnosis of neuropathy. Although symptoms, neurological deficits and abnormalities of nerve conduction are statistically associated, they should be evaluated separately to provide adequate characterization.