運動神経伝導速度よりみた糖尿病性神経障害

抄録

This study was undertaken to see the relationships between the maximum motor nerve conduction velocity of the ulnar nerve (MNCV) and the neurological manifestations or the clinical features of diabetic patient, and to find the factors influencing the MNCV. The diagnostic criteria of diabetic neuropathy was made by objective and/or subjective neurological signs in addition to the abnormal MNCV. The determination of the MNCV was made in 300 diabetic patients and 178 control subjects.
As the changes of the MNCV was observed during the glucose or fructose tolerance test, the determination of MNCV was mady at the fasting state in addition to the fixed room temperature.
On 86 inpatients, the renal biopsy, the fundscopic examination and the neurological studies were performed within a few days and the study of this group revealed that the neuropathy was the first to be recognized among the chronic complications (triopathy).
The decrease in MNCV was related to age, to the duration of the diabetic state, to the presence of the diabetic vascular complications and to the severity of the disease. The definite correlations were seen between the MNCV and body weight, arteriosclerosis (glomerulosclerosis), serum mucoprotein and serum total cholesterol. The MNCV decreased remarkably in ketotic state and this change was usually reversible.
The amelioration of the neurological disturbances in the hospitalized patients, was influenced by the severity of diabetic state at the discovery, by the control of fasting blood sugar and of blood pressure.
The juvenile diabetics had usually a poor prognosis of neuropathy particularly in the cases having recurrent attacks of hypoglycemia or ketosis.
A decrease of the MNCV was also observed in cases with liver disease or with liver dysfunction.
The evaluation of the vitamine B therapy was made by the MNCV determinations.