糖尿病患者の神経障害に関する臨床病理学的研究
とくに末梢神経を中心とした非糖尿病症例との比較検討
1964 年 7 巻 1 号 p. 26-38
詳細
1964 年 7 巻 1 号 p. 26-38
The autopsied fifty-five diabetic patients and fifty-nine non-diabetic controls were studied from the point of view of circulatory disturbance of the nutrient vessels and pathologic change of the nerves.
None of the controls had any malignant hypertension, peripheral nervous disease, and heart disease.
In all, 41 plexus brachialis (pars subscapularis), 45 vagal, 19 sciatic, and 21 femoral nerves of the diabetics were studied microscopically in cross section and and partly in longitudinal section.
The author investigated the arteriosclerotic changes of the large arteries (subclavicular artery, abdominal main artery, carotid artery & iliacal artery), observed microscopically the arteries (50-500μ in diameter) & arterioles (50μ in diameter) of the peri and intraneural vessels, according to the criteria of Blumenthal, counted the number of intraneural capillary blood vessel/mm2 and considered the relation between diabetic complications.
The results were as follows:
1) In the arterioles of the peripheral intraepineural nerves, the narrowing of the lumen of the arterioles of diabetics is marked in comparison with those of non-diabetics.
2) The number of capillary blood vessel/mm2 in diabetic nerves is decreased. And this change was seen in plexus brachialis, vagal and sciatic nerves.
3) Among diabetics, the above-mentioned observations are remarkable in the cases with diabetic complications.
4) The myelin sheath degeneration and the diffuse fibrosis of the peripheral nerves are more frequent in those of diabetics. Especially the changes of marked diffuse fibrosis or fatty degeneration are seen for the most part in the diabetic cases.
5) These histologic changes are mostly seen in the cases with clinically manifest symptoms of nervous disturbance, but sometimes seen in the cases with clinically latent symptoms, not only in the nerves which corresponds to the symptoms but also in those of upper extremities and lower extremities which do not always correspond to the symptoms, including autonomic nerves.
