自主神经功能检测对早期糖尿病自主神经功能损害诊断价值.doc

自主神经功能检测对早期糖尿病自主神经功能损害诊断价值 　 【关键词】; 糖尿病周围神经病 毕业论文 ; 作者简介：党静霞(1962)，主治医师. 研究方向：周围神经及肌肉疾病 毕业论文 　　摘要：目的; 评价自主神经功能检测对早期糖尿病自主神经功能损害的诊断价值。方法; 50例2型糖尿病患者进行自主神经功能检查，即交感皮肤反应和心血管自主神经功能检测，并与30名健康人进行对比分析。结果; 糖尿病患者自主神经功能检测中交感皮肤反应，瓦氏比值和深呼吸时心率变异与对照组比较均有显著性差异(Plt;0.05)，三者的异常率分别为70%，46%和50%；以交感皮肤反应的异常率最高，尤其以双下肢明显。立卧位血压差和冰水试验与对照组比较无显著性差异(Pgt;0.05)，其异常率分别为12%和16%。结论; 检测外周器官自主神经功能状态的方法中以交感皮肤反应的阳性率最高，可以作为检测早期糖尿病自主神经功能的常规筛选检查。 毕业论文 　　关键词：心血管自主神经功能；糖尿病周围神经病；心率变异；皮肤交感反应 　　 　　ABSTRACT: Objective; To evaluate the diagnostic value of autonomic nerve function tests for detecting the early diabetic autonomic dysfunction. Methods; Sympathetic skin response test, cardiovascular autonomic function tests were performed; in 50 type Ⅱ diabetic patients, and their results were compared and analyzed with those of 30 healthy subjects. Results; There was significant difference between the two groups for sympathetic skin response test, VR ratio and heart rate variability(Plt;0.05). The rates of abnormality were 70%, 46% and 50% respectively. Sympathetic skin response test had the highest abnormal rate which was 70%, on diabetic patients, more significant on both lower limbs. There was no significant difference between the two groups for orthostatic hypotension and ice test (Pgt;0.05). Abnormal rates were 12% and 16% respectively. Conclusion; Among the tests for detecting the peripheral autonomic dysfunction, sympathetic skin response test can be considered as a useful complementary method in detecting early diabetic autonomic disorders, and it is recommended for screening diabetic patients. 毕业论文 　　KEY WORDS: cardiovascular autonomic function; diabetic peripheral neuropathy; heart rate variability; sympathetic skin response 毕业论文 　　糖尿病周围神经病是糖尿病神经系统最常见的并发症，而自主神经构成了周围神经的主要组成部分。近年来糖尿病自主神经功能损害已经愈来愈受到重视，但其诊断率却很低。这主要是由于：症状缺乏特异性，并且效应器官受躯体内外环境的影响较大；尚缺乏一项有效的检查手段，导致漏诊和误诊。由于糖尿病周围神经病早期主要损害远端小纤维即自主神经纤维，因此可以通过检测自主神经系统所支配的远端效应器官如皮肤和心脏等来了解其自主神经功能，以达到早发现早治疗。我们通过对糖尿病患者进行交感皮肤反应(sympathetic skin response, SSR)，心血管自