激素对糖尿病与非糖尿病伴特发性面神经麻痹的疗效比较(1)
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[摘要] 目的:观察比较激素治疗对糖尿病(DM)与非DM伴特发性面神经麻痹(面瘫)的疗效。方法：回顾分析41例面瘫患者的临床资料，其中20例无DM史，21例有DM史，分别予常规激素治疗、短期激素治疗或不用激素治疗，比较3种治疗方法的不同效果。结果：不管是轻中度面瘫患者还是重度面瘫患者，非DM者用激素治疗效果最优，对于DM患者，轻中度患者用激素治疗效果比不用激素治疗者差，对于重度患者，用激素治疗与不用激素治疗差异没有显著性。DM者的神经传导速度(NCV)及瞬目反射(BR)的重度异常率均明显高于非DM者。结论：对于DM伴发的面瘫患者，不管病情轻重，尽量控制血糖在正常范围是基础；即使是重症患者，短期激素的使用也并不能改善患者的预后。
[关键词] 糖尿病； 面神经麻痹； 激素
[中图分类号] R587.1; R977.11 [文献标识码] A [文章编号] 1671-7562(2011)01-0005-05
doi:10.3969/j.issn.1671-7562.2011.01.002
[收稿日期] 2010-09-03 [修回日期] 2010-10-06
[作者简介] 周艳霞(1976-)，女，广东梅州人，主治医师。E-mail： xiaxue159@163.com
Electrophysiological findings and different effect with steroids treatment
of acute peripheral facial palsy in diabetic and non-diabetic patients
ZHOU Yan-xia， LONG Xia, LI Lu-jiang
(Department of Neurology, Shenzhen Second People's Hospital, Guangdong 518035, China)
[Abstract] Objective: To evaluate electrophysiological findings and different effects of steroids treatment for acute peripheral facial palsy in diabetic and non-diabetic patients. Methods: 41 patients with peripheral facial paralysis, 21 with diabetic mellitus and 20 without, were treated with conventional steroids therapy, short-term steroids therapy, without steroids therapy, the effects of three different treatment methods were compared. Results: For patients with mild to moderate or severe facial paralysis in non-diabetic group, steroids therapy was the best. Patients with mild to moderate facial paralysis in diabetic group achieved better effect of without hormone therapy than those hormone therapy; for severe patients, it did not make a difference. The diabetic patients had more abnormal rate of nerve conduction velocity and blink reflex than non-diabetic patients. Conclusion: It is essential to control blood sugar in a normal range for patients with facial palsy associated with diabetes regardless the severity. Short-term steroids therapy can not improve the prognosis for patients with serious facial paralysis combined with diabetes mellitus.
[Key words] diabetes； peripheral facial palsy； steroids
急性特发性面神经麻痹(以下简称面瘫)是指茎乳孔内非特异性炎症导致的周围性面瘫 ......
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