糖尿病神经病变的早期诊断:对当前诊断测试的审查
Minnan Al-Khafaji1, Vanessa Otti2
1Ophthalmology, The Royal London Hospital, London, GBR.
Cureus
|December 29, 2025
概括
早期发现糖尿病远端感觉运动性多神经病变 (DSPN) 对于预防并发症至关重要. 本综述探讨了有希望的诊断工具,用于在早期阶段识别DSPN,改善患者的治疗结果.
科学领域:
- 神经学 神经学
- 糖尿病学 糖尿病学
- 眼科医生 眼科 眼科
背景情况:
- 糖尿病经常导致远端感觉运动性多神经病变 (DSPN),导致疼痛和肢体损失.
- DSPN往往直到晚期才被发现,从而限制了早期干预的有效性.
- 目前的查方法缺乏对早期DSPN检测的敏感性.
研究的目的:
- 审查和评估用于早期检测DSPN的诊断方式.
- 突出评估小纤维功能的技术,以改善神经病变的诊断.
- 为解决对DSPN诊断工具标准化标准的需求.
主要方法:
- 对DSPN的各种诊断方式的审查,包括定量感官测试 (QST),通过皮肤活检检查皮肤内神经纤维密度 (IENFD),以及角膜共聚焦显微镜 (CCM).
- 对诸如Neuropad之类的运动测试进行评估,以检测亚临床神经病变.
- 讨论小纤维神经病变缺乏普遍参考标准所带来的挑战.
主要成果:
- 作为评估小纤维完整性的非侵入性,可重复的方法,CCM提供了实际优势.
- QST受到主观性和可变性的限制.
- 运动测试显示出检测亚临床神经病变的潜力,但具有适度的特异性.
结论:
- 早期的DSPN诊断对于及时干预和更好的血糖控制至关重要,显著改善患者的治疗结果.
- 对诊断标准的标准化和共识对于将新的DSPN检测工具纳入临床实践至关重要.
- 角膜共聚焦显微镜 (CCM) 为早期DSPN检测和监测提供了一个有希望的非侵入性选择.
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