糖尿病痛性神经病变 (2).ppt

*Theefficacyofduloxetineinimproving24-haveragepainscores.ReproducedfromReference38withpermissionoftheInternationalAssociationfortheStudyofPain(IASP).****Proportionofpatientsmeeting?50%and?30%improvementusingpregabalininsevenclinicaltrials.FreemanR,Durso-DecruzE,EmirB.Efficacy,safetyandtolerabilityofpregabalintreatmentofpainfuldiabeticperipheralneuropathy:findingsfrom7randomized,controlledtrialsacrossarangeofdoses.DiabetesCare2008;31:1448–1454.**均无RCT证据******Therearemanytypesofneuropathicpain.Thesearesomedatabasedonthepopulationof270millionbyBennettandcolleaguesdemonstratingthat600,000individualswouldhavepainfuldiabeticneuropathyconditionsonayearlybasis.Thesenumberscontinuetogoupwithpainfuldiabeticneuropathyandpostherpeticneuralgia.Asourpopulationshiftsinage,wearegoingtoseemoreandmorepostherpeticneuralgia.******在北京,上海,天津,重庆4个省市的10家中心医院，调查了3469例住院的2型患者慢性血管并发症的发病率及危险因素。OBJECTIVE:Toprovideanepidemiologicaldescriptionandriskfactorsofchronicvascularcomplicationsoftype2diabeticin-patientsinfourmunicipalitiesincludingBeijing,Shanghai,Tianjin,andChongqing.METHODS:Dataofthestudycamefrom3,469Type2diabeticin-patientsfrom1991to2000in10medicalcentersofBeijing,Shanghai,Tianjin,andChongqing.Avarietyofparametersofin-patientswereevaluatedretrospectivelytoknowtheprevalenceandriskfactorsofchronicvascularcomplicationsinthestudypatients.RESULTS:Overall,thedetailedprevalenceofchronicvascularcomplicationsislistedasfollows:diabeticretinopathy31.5%,diabeticnephropathy39.7%,diabeticneuropathy51.1%,hypertension41.8%,coronaryheartdisease(CHD)25.1%,cerebralvasculardisease(CVD)17.3%,vesselcomplicationoflowerlimbs9.3%.Multivariatelogisticregressionanalysisshowsthatdiabetesfamilyhistory,durationofdiabetes(5