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糖尿病性周围神经病的治疗
2011年
周围神经病变(diabetic peripheral neuropathy,DPN)为糖尿病最常见的神经并发症之一,表现为远侧端对称性多神经病变,患者出现疼痛,伴或不伴有感觉缺失,也可表现为自发性疼痛。疼痛症状开始出现在远侧端,影响双侧的脚趾和足,然后向上发展,累及下肢,病情进一步发展,上肢出现症状。
任占杰马立新倪家骧马骏
关键词:糖尿病性周围神经病周围神经病变自发性疼痛疼痛症状神经并发症对称性
Risk factors and pain status due to diabetic neuropathy in chronic long-term diabetic patients in a Chinese urban population被引量:10
2012年
Background With economic growth and urbanization there have been significant changes in the life style and diet of urban residents in large cities of China, which is experiencing a rapid increase in the prevalence of diabetes. While high prevalence of diabetes has been reported, little is known of the long-term effects of diabetes in such a large population. The aim of this study was to estimate the morbidity rate of diabetic peripheral neuropathy (DPN) in a Chinese urban diabetic population with more than 10 years' disease duration, and evaluate the relevant risk factors. The clinical manifestation of DPN and pain status was also assessed. Methods Five hundred and sixty-five diabetes patients were recruited into the study. Symptoms and examination helped diagnose neuropathy. The clinical manifestation of DPN was assessed with a visual analog pain score (VAS). Diabetic complication status was determined from medical records. Serum lipids and lipoproteins, glycosylated hemoglobin (HbAlc), and the urinary albumin excretion rate were measured. Results The morbidity rate of DPN was 46.6%. HbAlc, hyperlipidemia, and retinopathy were significantly associated with neuropathy, and these risk factors were correlated with other diabetic micro and/or macrovascular complications. The average VAS pain score of the DPN patients was 4.12+2.07. Severe and moderate pain was experienced by 11.4% and 40.5% respectively of DPN patients. About 3.7% of diabetic subjects had lower limb ulcer or amputation. Conclusions The morbidity rate of DPN for diabetic patients with 〉10 years duration is very high compared to the range reported for other populations in the world. The risk factors for DPN include HbAlc, hyperlipidemia, and retinopathy. In long-standing diabetic patients, DPN was not associated with diabetic duration, and half of the DPN patients experienced considerable daily suffering.
JI NaZHANG NanREN Zhan-jieJIA Ke-baoWANG LiNI Jia-xiangMA Jun
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