Radiology:同样是糖尿病周围神经病,为什么有的肢体疼痛,有的不疼痛呢?

2020-04-13 shaosai MedSci原创

糖尿病周围神经病(DPN)出现疼痛症状的病理生理学机制尚不明确。这可能与某些MRI征象具有相关性,但这尚无研究报告。

背景

糖尿病周围神经病(DPN)出现疼痛症状的病理生理学机制尚不明确。这可能与某些MRI征象具有相关性,但这尚无研究报告。

目的

本研究旨在评价DPN患者神经结构、神经病变负荷及空间分布、疼痛间的相关性。

 


材料与方法

本研究纳入了I型或II型糖尿病的患者。所有受试者均行3T MR神经成像,主要采用T2-压脂序列对坐骨神经进行成像。同时,患者进行临床和电生理测试。对于组间比较,利用方差分析和Kruskal-Wallis检验进行分析。利用Spearman相关性分析计算相关系数。

结果

本研究共纳入了131例受试者,I型糖尿病和II型糖尿病分别为45例、86例,痛性、无痛性以及无DPN患者分别为64例、37例和30例。痛性DPN组的病变体积(15.2% ± 1.6)占总神经体积百分百要高于无痛性DPN组(10.4% ± 1.7, P = .03)及无DPN组(8.3% ± 1.7; P < .001)。神经T2异常高信号病变的数量和程度与神经功能障碍评分(r = 0.37; 95% CI: 0.21, 0.52; r = 0.37; 95% CI: 0.20, 0.52)、神经病变症状评分(r = 0.41; 95% CI: 0.25, 0.55; r = 0.34; 95% CI: 0.17, 0.49)具有正相关性;神经T2异常高信号病变的数量和程度与与胫骨神经传导速度具有显著负相关velocity (r = -0.23; 95% CI: -0.44, -0.01; r = -0.37; 95% CI: -0.55, -0.15)。神经横断面面积与神经功能障碍评分具有正相关(r = 0.23; 95% CI: 0.03, 0.36),与胫骨神经传导速率具有负相关(r = -0.24; 95% CI: -0.45, -0.01)。

结论

本研究表明,痛性糖尿病周围神经病T2异常高信号病变数量和程度要比无痛性糖尿病周围神经病患者明显。这表明神经纤维素近端受损与糖尿病周围神经病痛性感觉症状进展具有相关性。

原始出处:

Jende JME , Groener JB, Kender Z. et al. Structural Nerve Remodeling at 3-T MR Neurography Differs between Painful and Painless Diabetic Polyneuropathy in Type 1 or 2 Diabetes. DOI:10.1148/radiol.2019191347

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    2020-06-06 爱学习的浦城人

    痛的程度和神经受损程度具有相关性

    0

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    2020-04-15 axin012
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    2020-04-13 misszhang

    谢谢MedSci提供最新的资讯

    0

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