2型糖尿病患者视觉诱发电位改变及其相关因素分析

目的探讨2型糖尿病患者视觉诱发电位(pattern visual evoked potential,P-VEP)改变的特点及其与各临床因素之间的关系。方法对109例2型糖尿病患者及40例健康体检者进行P-VEP的检测,病例组按病程分为病程<5年组、5年≤病程<10年组、病程≥10年组。回顾性分析各组生化指标、肌电图等临床资料与P-VEP改变的相关性。应用SPSS统计软件进行统计学处理。结果病例组P-VEP总异常率为27.52%,病程<5年组P-VEP异常8例(20.00%),5年≤病程<10年组P-VEP异常8例(25.81%),病程≥10年组P-VEP异常14例(36.84%),各组间其异常率比较差异无统计学意义(P>0.05)。P100潜伏期的改变:病程≥10年组的P100潜伏期较对照组明显延长(P<0.05),病程<5年组、5年≤病程<10年组的P100潜伏期较对照组无明显变化(P>0.05)。P100枕中波幅改变:5年≤病程<10年组,病程≥10年组的枕中波幅较对照组明显降低(P<0.05),病程<5年组的枕中波幅较对照组无明显变化(P>0.05)。周围神经病变严重组(病变神经数>4条)的枕中波幅较周围神经病变较轻组(病变神经数≤4条)明显降低(P<0.05)。非条件Logistic逐步回归分析显示病程和糖化血红蛋白是2型糖尿病患者视力损害的相关因素。结论 P-VEP是早期发现2型糖尿病患者视神经病变的无创检测手段。病程和糖化血红蛋白是2型糖尿病患者视神经病变的相关因素。

Analysis of pattern visual evoked potential and relevant factors in patients with type 2 diabetes

Objective To study the characteristic of pattern visual evoked potentials(P-VEP) in patients with type 2 diabetes and the relationship between the clinical factors and P-VEP.Methods In this study,109 patients with type 2 diabetes were divided into three subgroups according to the disease duration,<5 years group,5≤course duration <10 years group,≥10 years group.Patients and 40 healthy controls were analyzed retrospectively regarding clinical data,blood biochemicals,electromyography(EMG) and P-VEP changes.The results were analyzed by SPSS statistical software.Results The abnormal rate of P-VEP was 20.00% in <5 years group(8 cases),25.81% in 5 ≤course duration <10 years group(8 cases),and 36.84% in ≥10 years group(14 cases),with the mean abnormal rate of 27.52%.There was no statistically significant difference among the three diabetic groups(P>0.05).The amplitude was lower significantly in 5≤ course duration <10 years group and ≥10 years group compared with the control group(both P<0.05).There was no significant difference in the amplitude between the two groups(P>0.05).The latency of P100 was longer in ≥10 years group significantly than that in the control group(P<0.05).There was no statistically significant difference of the P100 latency between the two groups(P>0.05).In the severe group(the number of diseased nerve>4),the amplitude was lower significantly than that in the less serious group(the number of diseased nerve≤4)(P<0.05).Non-conditional logistic regression analysis showed that course and glycosylated hemoglobin(HbALc) were the relevant factors of visual impairment in patients with type 2 diabetes.Conclusions P-VEP was a non-invasive method for the early detection of optic neuropathy in patients with type 2 diabetes.The course of disease and HbALc level were the relevant factors of visual impairment in patients with type 2 diabetes.