标准化F波潜伏期对糖尿病周围神经病的诊断价值

目的探讨标准化F波潜伏期在糖尿病周围神经病(DPN)中的诊断价值。方法采用前瞻性研究方法,收集神经传导检查正常的DPN患者48例,另选择年龄和性别匹配的健康自愿者48名为对照组。采用肌电图诱发电位仪检测两组正中神经、尺神经、胫神经及腓总神经F波最短潜伏期(FLmin)、F波平均潜伏期(FLmean)、F波潜伏最长期(FLmax),并结合臂长和腿长计算标准化FLmin、标准化FLmean、标准化FLmax。比较两组间F波潜伏期及标准化F波潜伏期的差异,采用ROC曲线分析不同F波潜伏期在DPN中的诊断价值。结果除尺神经身高标准化FLmax外,DPN组4条神经的肢长和身高标准化F波潜伏期均较对照组延长(P<0.01或P<0.05)。ROC曲线分析显示,除尺神经常规F波潜伏期及身高标准化FLmean和FLmax外,4条神经常规F波潜伏期、身高标准化F波潜伏期及肢长标准化F波潜伏期对DPN均有诊断价值,ROC曲线下面积(AUC)为0.631~0.995(P<0.05),其中正中神经、尺神经、胫神经和腓总神经的肢长标准化FLmin的诊断价值最高,其AUC分别为0.995、0.934、0.940、0.969(均P<0.01)。结论针对神经传导检查正常的DPN患者,标准化F波潜伏期优于常规F波潜伏期,其中肢长标准化F波潜伏期的诊断价值优于身高标准化F波潜伏期。标准化F波潜伏期可作为临床诊断DPN的一个参考指标。

Diagnostic value of standardized F-wave latency in diabetic peripheral neuropathy

Objective To discuss the diagnostic value of standardized F-wave latency in diabetic peripheral neuropathy(DPN).Methods In this prospective study,48 DPN patients with normal nerve conduction were collected,and 48 healthy volunteers matched by age and sex were selected as the control group.The minimum latency(FLmin),average latency(FLmean)and maximum latency(FLmax)of F-waves in the median nerve,ulnar nerve,tibial nerve and common peroneal nerve were measured by an electromyography evoked potential instrument,and the standardized FLmin,standardized FLmean and standardized FLmax were calculated combined with arm length and leg length measurements.The differences of F-wave latency and standardized F-wave latency between the two groups were compared,and the diagnostic value of different F-wave latency in DPN was analyzed by ROC curve.Results Except for the height standardized FLmax of the ulnar nerve,the limb length standardized F-wave latency and height standardized F-wave latency of four nerves in DPN group were longer than those in the control group(P<0.01 or P<0.05).ROC curve analysis showed that in addition to the conventional F-wave latency and height standardized FLmean and FLmax of the ulnar nerve,the conventional F-wave latency,height standardized F-wave latency and limb length standardized F-wave latency of four nerves were statistically significant for the diagnosis of DPN.The area under the ROC curve(AUC)was 0.631-0.995(P<0.05).Among them,the limb length standardized FLmin of the median nerve,ulnar nerve,tibial nerve and common peroneal nerve had the highest diagnostic value,and their AUC were 0.995,0.934,0.940 and 0.969 respectively(all P<0.01).Conclusions For DPN patients with normal nerve conduction examination,the standardized F-wave latency is better than the conventional F-wave latency,and the diagnostic value of limb length standardized F-wave latency is better than height standardized F-wave latency.The standardized F-wave latency can be used as a reference index for clinical diagnosis of DPN.