神经传导速度和皮肤交感反射对糖尿病周围神经病变的早期诊断价值

目的探讨神经传导速度(NCV)和皮肤交感反射(SSR)对糖尿病周围神经病变(DNP)的早期诊断价值。方法对36例无明显周围神经病变症状的2型糖尿病患者(DM组)与36例健康者(对照组)进行NCV和SSR测定。比较两组NCV、SSR及DM组上下肢NCV和SSR异常。结果 DM组正中神经、尺神经和腓总神经的MCV及正中神经、尺神经和腓肠神经的SCV均明显低于对照组(P<0.01);DM组上肢与下肢的起始潜伏期均较对照组明显延长(P<0.01),两组上肢与下肢的波幅无显著性差异(P>0.0.5);NCV和SSR下肢异常率均明显高于上肢(P<0.05),SSR总异常率明显高于NCV(P<0.01)。结论 NCV和SSR都是早期诊断DNP的客观指标,尤其是SSR能更早发现周围神经损害,对早期诊断和治疗DNP具有重要意义。

The Value of Nerve Conducting Velocity and Sympathetic Skin Responses for Early Diagnosis of Diabetic Peripheral Neuropathy

Objective To investigate the value of nerve conducting velocity(NCV)and sympathetic skin responses(SSR)for early diagnosis of diabetic peripheral neuropathy.Methods A total of 36 cases of type 2 diabetes(DM group)without obvious symptoms of peripheral neuropathy and 36 healthy subjects(control group)were tested NCV and SSR.The NCV,SSR of the two groups and the upper and lower extremities abnormal SSR and NCV in DM group were compared.Results The MCV of median nerve,ulnar nerve and nervous peroneus communis and the SCV of median nerve,ulnar nerve and sural nerve in DM group were significantly lower than that of control group(P<0.01).The upper and lower extremities initial incubation period of the DM group was significantly longer than the control group(P<0.01),upper and lower extremities amplitude was no significant difference of two groups(P>0.0.5);Lower extremities NCV and SSR abnormalities rates were significantly higher than the upper extremities(P<0.05),the total abnormalities rates of SSR was significantly higher than NCV(P<0.01).Conclusion NCV and SSR are objective indicators for early diagnosis of DNP,especially that SSR can be used to detect peripheral nerve damage earlier,which has a great significance for early diagnosis and treatment of DNP.