CAJ | 학술논문

　　目的：观察糖耐量减低（IGT）患者神经传导速度（NCV）和交感皮肤反应（SSR）的变化。方法：对25例IGT患者（IGT组）、32例2型糖尿病（DM）患者（DM组）及18名对照者（对照组）进行一侧肢体NCV检测和四肢SSR检测。结果：与对照组相比，IGT组（除腓神经外）各根神经NCV均有不同程度减慢，但差异均无统计学意义；DM组（除胫神经外）各根神经NCV与对照组相比差异均减慢（P<0.05）。IGT组双下肢SSR起始潜伏期与对照组相比延长（P<0.05）；与对照组相比，DM组四肢SSR起始潜伏期显著延长、波幅显著降低（P<0.01）。对照组、IGT组和DM组NCV异常率分别为5.56%、28.00%、65.63%，SSR异常率分别为33.33%、72.00%、93.75%，3组间NCV和SSR异常率均有显著差异（P<0.01）。在IGT和DM组中，SSR异常率均高于NCV异常率，且无症状者亦有一定的NCV和SSR异常率。结论：IGT患者存在临床或亚临床周围神经损害，以小纤维受累为主，大纤维受累较少且局限于感觉纤维；SSR对糖代谢紊乱相关的周围神经损害的早期诊断敏感性优于NCV，但其特异性较差。
　　목적：관찰당내량감저（IGT）환자신경전도속도（NCV）화교감피부반응（SSR）적변화。방법：대25례IGT환자（IGT조）、32례2형당뇨병（DM）환자（DM조）급18명대조자（대조조）진행일측지체NCV검측화사지SSR검측。결과：여대조조상비，IGT조（제비신경외）각근신경NCV균유불동정도감만，단차이균무통계학의의；DM조（제경신경외）각근신경NCV여대조조상비차이균감만（P<0.05）。IGT조쌍하지SSR기시잠복기여대조조상비연장（P<0.05）；여대조조상비，DM조사지SSR기시잠복기현저연장、파폭현저강저（P<0.01）。대조조、IGT조화DM조NCV이상솔분별위5.56%、28.00%、65.63%，SSR이상솔분별위33.33%、72.00%、93.75%，3조간NCV화SSR이상솔균유현저차이（P<0.01）。재IGT화DM조중，SSR이상솔균고우NCV이상솔，차무증상자역유일정적NCV화SSR이상솔。결론：IGT환자존재림상혹아림상주위신경손해，이소섬유수루위주，대섬유수루교소차국한우감각섬유；SSR대당대사문란상관적주위신경손해적조기진단민감성우우NCV，단기특이성교차。
Objective:To observe the changes of nerve conduction velocity (NCV) and sympathetic skin reflex (SSR) in patients with impaired glucose tolerance (IGT). Methods:NCV of bilateral side of the body and SSR of 4 limbs test were performed in 25 IGT patients(IGT group), 32 diabetes mellitus (DM) patients (DM group) and 18 controls(control group). Results:Compared with the control group, the NCV in the IGT group (except the peroneal nerve ) was slow but without statistical significance, while the NCV in the DM group of every nerves (except the tibial nerves) was significantly slow (P<0.05). Compared with the control group, the onset latencies of the lower limbs were prolonged significantly in the IGT group (P<0.01). In the DM group, the on-set latencies of the 4 limbs were also prolonged significantly and the amplitudes were also decreased signifi-cantly (P<0.01). The abnormality rates of NCV in the control group, IGT group, DM group were 5.56%, 28.00%, 65.63%respectively. And the abnormality rate of SSR in the three groups was 33.33%, 72.00%, and 93.75%respectively. The abnormality rates of both NCV and SSR was significantly different among the three groups (P<0.01). In both IGT and DM group, the SSR abnormality rate was higher than that of NCV. And pa-tients without peripheral nerve impairment symptoms in the two groups showed a certain percentage of abnor-mality in SSR and NCV. Conclusion:Clinical or subclinical peripheral nerve impairment could be found in the IGT patients, with the predominant damgae of small fibers. The large fibers were affected less and confined to sensory nerves. Compared with NCV, SSR has better sensitivity for the early diagnosis of peripheral nerves damage associated with disturbed glucose metabolism with poor specificity.