神经传导速度及交感皮肤反应检测在糖尿病性周围神经病诊断中的价值

目的 探讨神经传导速度及交感皮肤反应（SSR）在糖尿病性周围神经病（DPN）诊断中的价值。方法 对36例DPN患者进行神经电图检查，包括运动神经传导速度（MCV）、感觉神经传导速度（SCV）及交感皮肤反应（SSR）检测。结果 共检查36例患者216条神经，其中MCV检测108条神经，MCV减慢32条，MCV减慢合并远端潜伏期延长8条，复合肌肉动作电位（CMAP）波幅下降4条，异常率40．7％；SCV检测108条神经，SCV减慢42条，未引出电位7条，SCV减慢伴波幅下降6条，异常率50．9％：SSR检测36例72侧肢体，其中有4例上、下肢均未引出SSR，22例38肢SSR潜伏期延长：波幅下降，异常率63．8％，10例无自主神经症状患者中有3例SSR异常，异常率30％。结论 NCV及SSR检测为DPN自主神经及周围神经早期病变，尤其是为亚临床病变提供了客观依据，多个参数相结合有助于提高早期病变的阳性检出率。

The value of electroneurograms and sympathetic skin response for diagnosing diabetic peripheral neuropathy

Objective To observe the value of electroneurograms and sympathetic skin response (SSR) in diagnosing diabetic peripheral neuropathy( DPN). Methods The electroneurophysiological data on 36 patients with DPN, including motor nerve conduction velocity (MCV) data, sensory nerve conduction velocity (SCV) data and sympathetic skin response ( SSR) data, were analyzed retrospectively. Results Two hundred and sixteen nerves of 36 patients with DPN were inspected. Among 108 nerves tested for MCV, 32 were found to have slowed down, 8 of them with the prolongation of distal delitescence. The amplitudes of compound muscle action potential (CMAP) induced by stimulation of 4 nerves were found to have decreased. The abnormality rate was 40. 7% . Among 108 nerves tested for SCV, 42 were found to have slowed down, 7 were tested with no potential elicited, and 6 were found to have decreased SCV with the prolongation of distal delitescence. The abnormality rate was 50. 9% . Seventy-two limbs of 36 patients with DPN were inspected. Four patients showed no SSR in both their upper and lower limbs. For 38 limbs of 22 patients, the SSR latency was found to be prolonged and the SSR amplitudes were found to have decreased. The abnormality rate was 63.8% . Among 10 patients without neuropathy, 3 patients' SSR was found to be abnormal, an abnormality rate of 30% . Conclusion Electroneurograms and SSR are sensitive indices for the diagnosis of DPN. Their diagnostic sensitivity can be improved if all the parameters are used together.