糖尿病并发症患者的神经病变模式不同。

M E Kiziltan, G Benbir
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引用次数: 0

摘要

目的:糖尿病多发神经病变(PNP)是足部溃疡的重要危险因素。糖尿病性皮肤病多见于糖尿病性神经病变患者。我们比较了不同性别的足部溃疡和糖尿病性皮肤病(DD)的PNP定位/复发的临床和电生理特征。方法:对88例糖尿病患者(男44例,女44例)进行详细的病史、病变相关资料和临床检查。神经传导速度(NCV)、复合运动动作电位(CMAP)、远端潜伏期(DL)和感觉神经动作电位从左右腓神经、右正中/尺神经进行评估。结果:DD在男性中更为常见(p < 0.001)。尺神经的平均NCV较慢(p < 0.001);平均CMAP值较低(p = 0.006);男性的平均DL比女性长(p = 0.003)。虽然腓神经的肌电特征无显著差异,但糖尿病男性腓神经受累更常见、更严重(p = 0.004)。腕管综合征在女性中更为常见,但并不显著。右侧溃疡患者的右侧腓神经CMAP振幅低于左侧腓神经(p = 0.009)。结论:我们的研究结果表明尺神经更常见于男性,CMAP较低,NCV值较慢,DL值较长。
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Neuropathy patterns differ in patients with diabetic complications.

Purpose: Diabetic polyneuropathy (PNP) is an important risk factor for foot ulcers. Diabetic dermopathy is more frequent in patients with diabetic neuropathy. We compared clinical and electrophysiological characteristics of PNP localizations/recurrences of foot ulcers, and diabetic dermopathy (DD) between sexes.

Methods: Eighty-eight diabetic patients (44 men, 44 women) had an evaluation regarding detailed history of their diseases, lesion-related data, and clinical examination. Nerve conduction velocities (NCV), compound motor action potentials (CMAP), distal latencies (DL), and sensory nerve action potentials were assessed from the right and left peroneal, right median/ulnar nerves.

Results: The presence of DD was more common in men (p < 0.001). The mean NCV of ulnar nerves was slower (p < 0.001); mean CMAP values were lower (p = 0.006); and mean DL was longer in men with compared to women (p = 0.003). Although EMG features of peroneal nerves showed no significant difference, diabetic men had more common and severe peroneal nerve involvement (p = 0.004). Carpal tunnel syndrome was more common in women, though not significant. Patients with right-sided ulcers had lower CMAP amplitudes on the right peroneal nerves in regard to left peroneal nerves (p = 0.009).

Conclusions: Our findings suggest that ulnar nerves are more commonly involved in men, with lower CMAP slower NCV values, and longer DL values.

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