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Нервно-мышечные болезни

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Поиск патогенетической терапии диабетической дистальной симметричной полинейропатии


https://doi.org/10.17650/2222-8721-2013-0-3-8-15

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Аннотация

Диабетическая дистальная симметричная полинейропатия (ДДСП) встречается приблизительно у трети больных с диабетом и ассоциируется с выраженными болевыми синдромами и повышенной смертностью. Диагностика и клиническая оценка ДДСП остается непростой проблемой не только для врачей общей практики, но и для специалистов, принимающих участие в клинических испытаниях. Оптимальный контроль диабета является первоочередной задачей в профилактике развития и ведении пациентов с ДДСП. Однако одного гликемического контроля недостаточно для предотвращения развития и прогрессирования ДДСП, особенно при диабете 2-го типа. Кроме того, у значительной части больных не удается достичь нормогликемии. Значительные успехи достигнуты в контроле симптоматических нейропатических болей, но при этом остается проблема сенсорного дефицита и патогенеза ДДСП. Выбор терапевтических возможностей влияния на естественное течение болезни ограничен. Исследовано несколько патогенетических терапевтических подходов, но результаты клинических испытаний не далиожидаемых результатов, а в некоторых случаях даже оказались разочаровывающими. Несмотря на это, в ряде рандомизированных контролируемых исследований по использованию патогенетического лечения показано обнадеживающее клиническое улучшение относительно нейропатических нарушений в конечных точках, особенно при использовании α-липоевой кислоты и актовегина. Возможность влияния на течение ДДСП требует дальнейшего подтверждения в клинических исследованиях наряду с пониманием механизмов действия многообещающего лечения.

Об авторах

Andrew JM Boulton
Centre for Endocrinology and Diabetes, University of Manchester, Manchester, UK
Россия


Peter Kempler
1st Department of Medicine, Semmelweis University, Budapest, Hungary
Россия


Alexander Ametov
Russian Medical Academy for Advanced Studies, Moscow, Russia
Россия


Dan Ziegler
Institute for Clinical Diabetology, German Diabetes Center at the Heinrich Heine University, Leibniz Center for Diabetes Research, Department of Metabolic Diseases, University Hospital, Düsseldorf, Germany
Россия


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Для цитирования:


JM Boulton A., Kempler P., Ametov A., Ziegler D. Поиск патогенетической терапии диабетической дистальной симметричной полинейропатии. Нервно-мышечные болезни. 2013;(3):8-15. https://doi.org/10.17650/2222-8721-2013-0-3-8-15

For citation:


., ., ., . . Neuromuscular Diseases. 2013;(3):8-15. (In Russ.) https://doi.org/10.17650/2222-8721-2013-0-3-8-15

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