医学论文-2型糖尿病患者病程中下肢神经和血管功能检测指标的变化.docVIP

医学论文-2型糖尿病患者病程中下肢神经和血管功能检测指标的变化 ??????????????????????????? 作者：杨建军 崔世维 朱晓晖 王粹芳 朱静仪 【摘要】? 目的? 研究2型糖尿病患者下肢神经和血管功能检测指标的变化规律。方法? 检测神经和血管功能检测指标，比较它们在两侧下肢、溃疡前后的差别及它们之间的相关性。结果? 无足部溃疡的患者：检测指标左右两侧都没有差异(P0.05)，ABI和震动觉均数在正常范围内，触觉、疼痛觉和温度觉均数不在正常范围内。有足部溃疡的患者：溃疡侧足的各种指标都明显降低(P 0.05)。ABI与神经指标之间没有相关性(P 0.05)。神经指标相互之间都有相关性(P 0.05)。结论? 糖尿病患者两下肢神经和血管功能在出现溃疡之前，左右两侧无明显区别；一旦出现足溃疡后，溃疡侧的指标会明显下降。触觉、疼痛觉和温度觉是相对较早的指标。ABI和震动觉是相对较晚的指标。神经和血管的损害具有不同的机制。【关键词】? 2型糖尿病? 神经检测? 血管检测【Abstract】 Objective：To investigate the examination indexes change of the lower limbs nerve and artery funtion during the course of the type 2 diabetes mellitus (T2DM) patients. Methods:Detection of nerve and vascular function test indicators,compare them to both sides of the lower extremities,ulcers before and after the differences and the correlation between them. Results：No ulcer: There was no difference between left and right lower limbs(P＞0.05). ABI and vibration sense are a few within the normal range，touch、feel pain and temperature sensation does not mean witin the normal range.Ulcer: The indexes of the ulcer limb were obviously lower compaird with no ulcer limb(P＞0.05). There was no correlation between ABI and nerve indexes(P＞0.05). Neurological indicators are relevant to each other(P＞0.05).Conclusions：2 diabetes lower limb nerve and vascular function in the event of ulcer before was no significant difference between right and left sides.The function of ulcer limb can obviously decline once the ulcer appears. Tactile,pain perception and temperature sensation are relatively early indicators.ABI and ribration sense are relatively late indicators.The harm of never and vein has different pathogenesis.【Key words】 T2 Diabetes Mellitus? Nerve Function? Artery Function??????? 臂-踝指数(ABI)检测对于下肢周围血管病变具有肯定的预测作用[1]。震动觉[2]、触觉[3]、疼痛觉[4]和温度觉[5]检测在鉴定下肢周围神经病变中同样具有较高的敏感性。本研究旨在比较这些检测指标在病程发展中的变化规律，以更好地指导临床工作。??????? 1? 方法??????? 1.1入选对象? 2007年10月至2009年6月在南通大学附属医院内分泌科住院的糖尿病患者，共971例。??????? 1.2入选标准? 年龄≥40岁，２型糖尿病，能正确配合检查的住院患者。??????? 1