A PRACTICAL 2-STEP QUANTITATIVE CLINICAL AND ELECTROPHYSIOLOGICAL ASSESSMENT FOR THE DIAGNOSIS AND STAGING OF DIABETIC NEUROPATHY
A PRACTICAL 2-STEP QUANTITATIVE CLINICAL AND ELECTROPHYSIOLOGICAL ASSESSMENT FOR THE DIAGNOSIS AND STAGING OF DIABETIC NEUROPATHY
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DOI：
10.2337/diacare.17.11.1281
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发表时间：
1994-11-01
期刊：
影响因子：
16.2
通讯作者：
GREENE, DA
中科院分区：
文献类型：
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作者：
FELDMAN, EL;STEVENS, MJ;GREENE, DA
目的 - 远端对称性感觉运动性多发性神经病（糖尿病的常见并发症）的早期诊断可能会通过潜在的治疗干预来降低患者的发病率。我们设计了一个门诊计划来促进糖尿病神经病变的诊断。 研究设计和方法 - 最初对患者进行简短的问卷调查和筛查检查，指定为密歇根神经病变筛查仪器（MNSI）。通过阳性检查和神经传导研究证实糖尿病神经病变，称为密歇根糖尿病神经病变评分（MDNS）。在这项研究中，根据圣安东尼奥共识声明 (1) 和梅奥诊所方案 (2)，对 56 名确诊 I 型或 II 型糖尿病的门诊患者进行了诊断和分期糖尿病神经病变所需的标准化定量成分。然后对这些患者进行 MNSI 和 MDNS 评估。 结果：在 29 名临床 MNSI 评分 > 2 的患者中，28 名患有神经病。 MDNS 大于或等于 7 的 28 名患者患有神经病变，而 21 名非神经病变患者的评分小于或等于 6。在 35 名糖尿病神经病变患者中，34 名患者有大于或等于 2 的神经传导异常。 21 名正常患者和 1 名神经病变患者的神经传导异常少于或等于 1 个。结论 - 结果表明 MNSI 是糖尿病神经病变的良好筛查工具，并且 MDNS 与神经传导相结合提供了一种简单的方法来确认这一诊断。
OBJECTIVE - Early diagnosis of distal symmetric sensorimotor polyneuropathy, a common complication of diabetes, may decrease patient morbidity by allowing for potential therapeutic interventions. We have designed an outpatient program to facilitate diagnosis of diabetic neuropathy.RESEARCH DESIGN AND METHODS - Patients are initially administered a brief questionnaire and screening examination, designated the Michigan Neuropathy Screening Instrument (MNSI). Diabetic neuropathy confirmed with a positive examination coupled with nerve conduction studies, designated the Michigan Diabetic Neuropathy Score (MDNS). In this study, 56 outpatients with confirmed type I or II diabetes were administered the standardized quantitative components required to diagnose and stage diabetic neuropathy according to the San Antonio Consensus Statement (1) and the Mayo Clinic protocol (2). These same patients were then assessed with the MNSI and the MDNS.RESULTS- Of 29 patients with a clinical MNSI score > 2, 28 had neuropathy. Twenty-eight patients with an MDNS of greater than or equal to 7 had neuropathy, while 21 nonneuropathic patients had a score less than or equal to 6. Of 35 patients with diabetic neuropathy, 34 had greater than or equal to 2 abnormal nerve conductions. Twenty-one normal patients and one patient with neuropathy had less than or equal to 1 abnormal nerve conduction.CONCLUSIONS - The results indicate that the MNSI is a good screening tool for diabetic neuropathy and that the MDNS coupled with nerve conductions provides a simple means to confirm this diagnosis.