老年糖尿病患者肋间神经刺激体感诱发电位研究

目的 :探讨肋间神经刺激体感诱发电位 (ISEP)对评价老年糖尿病 (DM)患者躯干神经功能障碍的价值 ,并分析引起ISEP异常的相关因素。方法 :对 5 2例正常人 ,35例老年DM病人在双侧第3、5、7、9肋间隙刺激 ,皮层C1、C2 记录ISEP ,同时进行运动诱发电位、体感诱发电位、脑干听觉诱发电位位、耳蜗电图、视觉诱发电位等电生理检查 ,并分析与血液生化检查异常的相关关系。结果 :老年DM病人ISEP异常 2 6例 ,异常率 74%。与正常对照组相比有显著性差异 ,ISEP与餐后血糖、空腹血糖、糖化血红蛋白、病程、血清胰岛素及C肽水平呈正相关 (r=0 2 43～ 0 90 5 ,P =0 0 1～ 0 0 5 )。结论 :ISEP可客观评价胸部神经根病 ,可作为糖尿病病人胸段神经根病、肋间神经痛等疾病早期诊断及预后判断的依据。

Study of intercostal nerre stimulation somatosensory evoked potentials in senile patients with diabetes mellitus

Objectives:To explore the value of intercostal nerves somatosensory evoked potentials (ISEPs) in evaluating the function disorders of somatosensory nerve in senile patients with diabetes mellitus (DM), and relative factors causing abnormal ISEP were analyzed.Methods:ISEPs were recorded on C 1,C 2 of cortex by stimulating bilateral 3,5,7,9 intercostal spaces in 35 senile patients with DM and 52 normal subjects. Simultaneously, relative factors analysis was done between the electrophysiological determination (MEPs, SEPs, BAEPs and ECochGs) and abnormal blood biochemical findings. Results:ISEPs were abnormal in 26 senile patients with DM at a rate of 74.3%. A significant difference was noted as compared with the normal subjects, ISEPs had a positive correlation with plasma glucose after meal, free meal plasma glucose, glycosylation Hb, coure of disease, plasma level of insulin and peptide C.Conclusion:ISEPs might evaluate the thoracic radiculoneuropathy objectively. It might be served as evidences for diagnosing and predicting the prognosis of thoracic radiculoneuropathy and intercostal neuralgia.