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

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(P<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(P>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。

Significance of autonomic nerve function tests for early diagnosis of diabetic autonomic dysfunction

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(P<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(P>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.