Two-point discrimination in diabetic patients (糖尿病患者的两点辨别力)




Diabetes mellitus (DM) is a common cause of polyneuropathy. The aim of the present study was to evaluate two-point discrimination (TPD) compared with nerve conduction studies in the early stages of DM.


Forty-eight patients with early diagnosed (<5 years) type 2 DM and 17 healthy controls were evaluated. Of the patients with DM, 26 had neuropathic pain and 22 were asymptomatic. TPD and electrophysiological evaluations was obtained for all subjects.


Nerve conduction studies in patients showed findings related to both demyelination and axonal damage. Patients with neuropathic pain had higher TPD values on the plantar surface of the foot and both groups of DM patients had higher TPD values on the outer lateral malleolus compared with the control group (P < 0.05). There was a correlation between TPD and axonal damage in patients with neuropathic pain (P < 0.05). In patients without neuropathic pain, there was a correlation between TPD values and distal latencies of motor or sensory nerves (P < 0.05). In the control group, only third digit TPD values were related to the distal motor latency of the median nerve (P < 0.05).


In conclusion, the TPD method is a less painful, practical, costeffective, and more easily applicable method that was completed in less timethan nerve conduction studies. Higher TPD values in the lower extremities indicate nerve damage in patients. These findings suggest that increased TPD values can easily determine neuropathy starting in the early stages of diabetes in patients with DM.



糖尿病是多发性神经病变最常见的病因之一。本研究的目的是在处于早期阶段的糖尿病患者中比较测定两点辨别力(two-point discrimination, TPD)与神经传导研究。


评估了48名早期(< 5年)诊断的2型糖尿病患者以及17名健康对照者。在糖尿病患者中,26名患者有神经性疼痛,22名患者无症状。所有的受试者都要进行TPD与电生理学评估。


患者的神经传导研究结果显示与脱髓鞘以及轴突损害都有关系。与对照组相比较,有神经性疼痛的患者足底面的TPD值更高,并且两组糖尿病患者外踝面的TPD值都更高(P < 0.05)。在有神经性疼痛的患者中,TPD与轴突损害具有相关性(P < 0.05)。在没有神经性疼痛的患者中,TPD值与运动或者感觉神经的远端潜伏期具有相关性(P < 0.05)。在对照组中,只有第三指的TPD值与正中神经的远端运动潜伏期具有相关性(P < 0.05)。