糖尿病周围神经病变神经电生理特点分析

目的分析糖尿病周围神经病变（diabetic peripheral neuropathy，DPN）的临床与电生理特点。方法对2010年9月-2012年5月在武警总医院住院治疗的84例糖尿病周围神经病变患者的临床资料及电生理检测结果进行回顾性分析。结果神经电生理中感觉神经传导异常程度重于运动神经，波幅的下降程度较传导速度减慢明显，下肢重于上肢（P均〈0．05）；皮肤交感反射检测下肢的异常率高于上肢（P〈0．01）；糖尿病周围神经病变最常见的临床症状为肢体麻木；最常见的体征是感觉减退；神经传导异常组的病程、血糖及糖化血红蛋白水平均高于神经传导正常组P〈0．05）。结论DPN的临床和电生理表现均以感觉神经受损为主；早期通过神经电生理诊断时要同时行神经传导和皮肤交感反应检测；病程越长，血糖控制水平越差．神经电生理结果出现异常的可能性越大。

Neuroelectrophysiologic features in patients with diabetic peripheral neuropathy

Objective To analyze the clinical and electrophysiological features in patients with diabetic peripheral neuropathy （DPN）. Methods Clinical data about 84 DPN patients who underwent neuroelectrophysiologic test in General Hospital of Armed Police Forces from September 2010 to May 2012 were retrospectively analyzed. Results Neuroelectrophysiologic test showed that the abnormal rate of sensory nerve conduction was higher than that of motor nerve conduction （P 〈 0.05）, the amplitude was lower than conduction velocity and higher in lower extremities than in upper extremities （P 〈 0.05）, and the abnormal rate of skin sympathetic reflect was higher in lower extremities than in upper extremities （P 〈 0.01）. Limb numbness and hypoesthesia were the most common clinical symptom and sign in DPN patients. The course of DPN, blood glucose and glycosylated hemoglobin levels were higher in patients with abnormal nerve conduction than in those with normal nerve conduction （P 〈 0.05）. Conclusion Sensory nerve injury is the most common clinical and neuroelectrophysiologic manifestation in DPN patients. DPN should be diagnosed according to electrophysiological test, nerve conduction and skin sympathetic reflect. The longer the course of DPN is, the poorer the blood glucose control level is, and the worse the neuroelectrophysiologic test is.