皮肤交感电位在糖尿病自主神经病亚临床病变的诊断价值

目的探讨皮肤交感电位(SSP)与糖尿病自主神经病的相关性,为糖尿病自主神经病的早期诊断提供客观依据。方法对65例糖尿病合并自主神经病患者,60例糖尿病患者及40例健康人的四肢进行SSP测定,对3组SSP各潜伏期及波幅的均值进行比较分析。结果糖尿病非自主神经病组的SSP起始潜伏期、N波、P波潜伏期与正常对照组比较差异均有统计学意义(均P<0.01)、N波波幅,P波波幅差异无统计学意义(P>0.05)。糖尿病自主神经病组中,35例神经传导速度显示为神经纤维脱髓改变,为上肢及下肢SSP潜伏期显著延长,以下肢延长为著,在下肢延长的同时其波幅亦有降低,在神经传导速度显示的神经轴索损害的30例患者中,双下肢的SSP均未引出波形,而上肢SSP潜伏期明显延长,波幅降低。2组比较差异有统计学意义(P<0.01)。健康对照组全部引出SSP。结论SSP为糖尿病自主神经病的早期诊断提供了新的方法和诊断依据,可发现糖尿病自主神经病亚临床病变。

Evalntioll of sympathetic skin potential in diagnosis of diabetic vegetative neuropathy

Objective To study the association between the sympathetic skin potentiai (SSP ) and diabetic autonomic neuropathy,and to supply objective basis for early diagnosis of diabetic autonomic neuropathy.Methods 65 cases of diabetic peripheral neuropathy(DPN),60 diabetic patients and 40 normal controls were given SSP detection using electrophysiological measurements,and the average values of the latencies the and amplitudes were analyzed by t-test.Results SSP latencies (latencies of N wave,P wave )were significantly longer in the 60 diabetic patients with normal nerve conduction velocities in comparison with the normal group.There were no significant differences between SSP amplitude of N wave and P wave of the two groups.In a total of 65 diabetics with peripheral neuropathy (DPN), 35 were shocved as demy-elinated changes and 30 were axial injury.The SSP latencies were longer (the SSP amplitiudes were lower ) in the legs than that of the aims. Conclusion SSP has the potential to detect subclinical autonomic nervous system dysfunction,which provides a new method and diagnostic basis for early stage of diabetic autonomic neuropathy.