雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Ischaemic neuropathy and diabetic neuropathy Hitoshi Nukada 1 1Department of Medicine, University of Otago Medical School Keyword: 末梢神経 , 虚血 , 再灌流傷害 , 糖尿病 pp.605-617
Published Date 2003/8/10
DOI https://doi.org/10.11477/mf.1431100343
  • Abstract
  • Look Inside

 This review will focus on recent advances in the field of ischaemic and diabetic neuropathies, including underlying disorders of ischaemic neuropathy, morphological susceptibility of diabetic nerve to ischaemia/reperfusion, and reperfusion nerve injury. 1)Ischaemia has been implicated in the pathophysiology of many disorders of peripheral nerves, such as diabetic neuropathies, primary and secondary vasculitides, and occlusive arterial diseases. Ischaemic neuropathy causes mononeuritis multiplex, asymmetrical neuropathy, or symmetrial distal neuropathy. Peripheral nerve vasculitis and ischaemic monomelic neuropathy can be encountered in clinical practice and diagnosis can be challenging. 2)In contrast to the central nervous system, peripheral nerve is relatively resistant to ischaemic damage. After 5-6 hours of severe acute ischaemia, peripheral nerve is able to recover completely. However, if systemic disorders such as diabetes exist, the threshold to ischaemic damage in peripheral nerves is lowered, and severe morphological abnormalities can be induced by 2-3 hours of ischaemia. 3)Pathology in reperfusion nerve injury includes endoneurial oedema, intramyelinic oedema, demyelination at the border zone, axonal degeneration at ischaemic area, and panfasccicular necrosis resulting from no-reflow phenomenon. Demyelination in reperfusion injury can be caused by a direct invasion of macrophages, as seen in multiple sclerosis and Guil-lain-Barrésyndrome. Reactive oxygen metabolites and inflammatory leukocytes play a major role in the development of reperfusion nerve injury. 4)The study of chronic ischaemic neuropathy is limited because of a lack of experimental model. I hope future research will help to delineate the pathophysiology of chronic ischaemic neuropathy.


Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1243 印刷版ISSN 0001-8724 医学書院

関連文献

もっと見る

文献を共有