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당뇨병 환자에서 임상증상 및 자율신경장애와 감각신경장애와의 상관관계
김진오,유용규,문승혁,김효석,봉형근,변동원,서교일,조용욱,유명희,김극배 순천향대학교 1994 논문집 Vol.17 No.2
In a group of 47 diabetic patients and 60 controls, we measured vibration perception threshold with biothesiometer, and autonomic nerve function by means of the five classical cardiovascular tests (Valsalva ratio, R-R interval variations during deep breathing, sustained handgrip, lying to standing, and postural hypotension). Results of cardiovascular reflex results were compared with symptoms of autonomic dysfunction and vibration perception threshold. The object of this study was to assess the physiological and clinical correlation of autonomic and sensory neuropathy in diabetic patients and results of this study could be applying patients for therapeutic approach and follow up diabetic neuropathy. Vibration perception threshold correlated with Valsalva ratio(p<0.01) and deep breathing(p<0.01). Patients score was significantly lower than controls in vibration perception threshold and all of the autonomic function tests. According to the results of cardiovascular tests, patients were divided into two different groups : presence(DAN+: ≥3) or abscence(DAN-: <3) of autonomic neuropathy. DAN () group(n=25, 53.2%) showed no significant differences from the DAN(+) group(n=22, 46.8%) in age, fasting and 2 hours postprandial blood sugar, body mass index, and cholesterol but associated with duration of diabetes. Vibration perception threshold measured at the first toe tip and at external malleolus in DAN(+) patients were significantly higher than DAN () patients and controls. We diagnosed sensory impairment when vibration perception threshold value is above 95th percentile of controls and we observed a significant correlation between autonomic and sensory neuropathy. These findings suggested that there is a correlation between autonomic and sensory neuropathy in diabetic patients, even in the absence of symptoms.