交感皮肤反应对糖尿病自主神经病变的诊断价值

目的探讨交感皮肤反应（sympathetic skin response,SSR）在糖尿病自主神经病变诊断中的价值。方法对186例糖尿病周围神经病（Diabetic peripheral neuropathy,DPN）患者和203例糖尿病非DPN患者进行SSR检测,同时对102例健康人进行SSR检测。结果SSR起始潜伏期异常率高于波幅异常率,下肢的异常率高于上肢异常率。DPN患者中,174例（93.5%）SSR异常,其中32例未引出SSR,142例起始潜伏期延长,109例波幅下降。203例DM非DPN患者中,46例（22.7%）SSR起始潜伏期延长和/或波幅下降,其中19例有出汗异常,4例在检查后数月出现出汗异常。结论SSR是早期诊断糖尿病自主神经病变的敏感手段,可发现亚临床神经病,并与病情进展相吻合。

Diagnostic significance of sympathetic skin response in diabetic autonomic neuropathy

Objective To investigate the diagnostic value of sympathetic skin response （SSR） test in diabetic autonomic neuropathy. Methods SSR and nerve conduction velocity tests were performed in 186 diabetic peripheral neuropathy （DPN） and 203 diabetic mellitus patients without peripheral neuropathy, and their SSR results were compared and analyzed with those of 102 healthy subjects. Results The abnormity rate of the onset latency was higher than those of amplitude,and the abnormity rate of lower limbs were higher than those of upper limbs. In the 186 DPN,SSR were abnormal in 174 （93. 5%） cases,and 32 cases showed no SSR in their upper or lower limbs, 142 cases showed the onset latency prolonged, 109 cases showed the amplitudes decreased. In the 203 mellitus patients without peripheral neuropathy, the onset latency of SSR was found to be prolonged,and/or the amplitudes of SSR were found to have decreased in 46 （22. 7%） cases, 19 patients among them had the symptom of the autonomic neuropathy, and 4 patients had the symptom of the autonomic neuropathy months after test. Conclusions The detection of SSR could be served as sensitive means to early diagnosis of DPN,and may detect subclinical neuropathy, and keep in consistent with the development of the disease.