糖尿病
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
糖尿病性末梢神経障害の電気生理学的定量的評価
永木 譲治陣内 冨男
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1986 年 29 巻 sppl1 号 p. 43-45

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Motor and sensory nerve coduction studies were performed on 56 consecutive diabetic patients (NIDDM). Maximum conduction velocities of the motor and sensory nerves and action potential amplitudes of the sensory nerves were measured in the limbs. Twentyeight nerve measurements were obtained for each patient. In order to exclude the effects of age and to evaluate the nerve impairments quantitatively under standard conditions, the values measured in patients were represented as the percent of the the mean value in age-matched controls (‘percent’ representaion method). Based on the ‘percent’; representation method, the incidence of polyneuropathy in the diabetic patients and the nature of the degeneration of the peripheral nerves were clarified.
Out of 56 patients 27 (48.2%) had abnormal measurements in more than half of the 28 nerve measurements and were considered to have polyneuropathy. Fifteen patients (26.8%) were abnormal in less than half and the other 14 (25.0%) were normal in almost all the nerves tested.
A highly significant correlation was observed between motor and sensory conduction velocities and also between the conduction velocities of the forearms and legs. However, in the action potential amplitude and the conduction velocity of the sural nerve, the amplitude was more severely decreased than the conduction velocity. Such a decrease of amplitude is considered to reflect axonal loss, which is the main histopathological finding in diabetic polyneuropathy. Consequently, changes of amplitude in sensory nerve action potential are more important than those of conduction velocity in observing peripheral nerve impairments in diabetic patients.

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