糖尿病患者周围神经传导速度的研究

目的:通过周围神经传导速度(NCV)的研究,早期诊断糖尿病(DM)患者的糖尿病性周围神经病变。方法:应用上海海军医学研究所NDI-200F神经电检诊仪,对DM组95例患者行尺神经、正中神经、胫神经和腓神经运动传导速度(MCV)及尺神经、正中神经、腓肠神经感觉传导速度(SCV)检测与30例健康人组对照。结果:DM组95例, NCV异常率为77.89%(74/95)。共检测665条神经,MCV380条,异常率55.26%,SCV285条,异常率50.88%,差异无显著性意义(P>0.05)。上肢检测380条神经,异常率45.53%,下肢检测285条神经,异常率63.86%,差异有显著性意义(P<0.05)。DM组SCV波幅减低率为53.66%。DM组按病程分为三组,<5年,30例,异常率28.10%;≥5年,31 例,异常率为54.84%;≥10年,34例,异常率74.37%,组间差异均有非常显著性意义(P<0.01)。DM组中29例无周围神经病变症状与体征,NCV异常11例(37.93%)。结论:周围神经传导速度检测不但可以早期诊断糖尿病患者的糖尿病性周围神经病变,而且此方法可靠、简便、无创。

Study of peripheral nerve conduction velocity in patients with diabetes mellitus

Objective: To get the early diagnosis of diabetic peripheral neuropathy(DPN) with the study of peripheral nerve conduction velocity (NCV) in patients with diabetes mellitus(DM). Methods: Using NDI-200F System of Naval Medical Research Institute ShangHai to detect motor neuron conduction velocity(MCV) of ulnar, median, tibial, peroneal nerves, and sense neuron conduction velocity (SCV) of ulnar, median, peroneal nerves in patients with DM. Thirty healthy volunteers were assigned to control group. Results:The rate of NCV impainnent(RNl) was totally 77. 89%(74/95) in DM group(95 cases). NCV was determined in a total of 665 nerves. The RNI of MCV was 55. 26% (380 nerves) ,similar to that of SCV 50. 88% (285 nerves,P>0. 05). The lower limbs(63. 86% ,285nerves) was higher than that of the upper ones(45. 53% ,380 nerves). There was significant different between them(P<0. 05). The lower rate of amplitude of SCV was 53. 66% in DM group. 95 patients with DM were divided into three group based on the duration of the disease. The RNI of <5 years group(30 cases) was 28. 10% ,≥5 years group was 54. 84% (31 cases) ,≥10years group was 74. 37% (34cases). The defferent from respective group was significantly higher(P<0. 01). The RNI in DM group without clinical symptom and sign of diabetic neuropathy was 37. 93%(1 t cases). Conclusions:The detection of NCV can be used to diagnose DNP early in DM patients,and it is a reliable, simple, noninvasive method.