| 特集名 | 糖尿病性腎症の最前線 | |
|---|---|---|
| 題名 | 糖尿病透析患者の合併症 (6) 末梢神経障害 | |
| 発刊年月 | 2001年 01月 | |
| 著者 | 長谷川 節 | 国立療養所東宇都宮病院神経内科 |
| 著者 | 小坂 直之 | 東京慈恵会医科大学腎臓高血圧内科 |
| 著者 | 豊島 裕子 | 東京慈恵会医科大学環境保健医学講座 |
| 著者 | 細谷 龍男 | 東京慈恵会医科大学腎臓高血圧内科 |
| 著者 | 川口 良人 | 神奈川県立衛生看護学校附属病院 |
| 【 要旨 】 | 糖尿病と尿毒症ではいずれの病態でも左右対称性で遠位に強く，上肢より下肢に強く，運動より感覚障害が強いpolyneuropathyをきたす．通常，下肢遠位のdysesthesiaで発症し進行する． 今回，われわれは慢性腎不全患者を非糖尿病〔DM(－)〕群と2型糖尿病を合併し，血清HbA1c値に従って良好コントロール(good)群，不良コントロール(bad)群の3群に分類し，透析導入時の末梢神経伝導検査を解析した．正中，腓骨両神経の運動神経伝導速度と腓腹神経の感覚神経伝導速度はDM(－)群に比し，有意(p<0.05)にbad群で低下していた． この結果，糖尿病性腎症患者では糖尿病以外による腎障害患者より血糖コントロールが不良になると，polyneuropathyが重症になると考えられた． |
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| Theme | Forefront of Diabetic Nephropathy | |
|---|---|---|
| Title | Polyneuropathy associated with diabetic or nondiabetic uremic patients | |
| Author | Takashi Hasegawa | Department of Nephrology, National Higashi-utsunomiya Hospital |
| Author | Naoyuki Osaka | Division of Nephrology and Hypertension, Jikei University School of Medicine |
| Author | Hiroko Toshima | Department of Health and Environmental Medicine, Jikei University School of Medicine |
| Author | Tatsuo Hosoya | Division of Nephrology and Hypertension, Jikei University School of Medicine |
| Author | Yoshindo Kawaguchi | Kanangawa Prefectural Hospital Affilited with Nurses Traning School |
| [ Summary ] | Diabetic or uremic polyneuropathy is a symmetrical, distal, mixed motor and sensory polyneuropathy that affects the legs more than the arms. The first symptom for most patients with these neuropathies is dysensthesias of the lower distal extremities, which progressively spreads. We studied peripheral nerve conduction velocities in patients with end-stage renal failure, as well as hemodialised patients. Measurements were compared for nondiabetic uremic patients and two categorized groups of type 2 diabetic-uremic patients according to their serum HbA1c Motor nerve conduction velocity of median and peroneal nerves, and sensory nerve conduction velocity of sural nerves significantly decreased in the higher HbA1c diabetic group, less so than in the nondiabetic group (p<O.O5). Our results suggest that poorly contorolled diabetic uremic patients have more severe polyneuropathies than nondiabetic uremic patients. |
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