114例糖尿病患者神经电生理特征与相关因素分析

目的观察糖尿病患者神经电生理特征,分析糖尿病周围神经病变的相关危险因素。方法对114例糖尿病患者进行神经传导检测,并对糖尿病周围神经病变组(DPN)及神经传导正常(NDPN)组年龄、病程、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、血压及血同型半胱胺酸等进行分析。结果 114例2型糖尿病患者中94例出现周围神经病变,20例神经传导正常,总异常率82.5%。其中运动神经纤维受损:正中神经纤维异常率右侧31%,左侧19%;尺神经纤维异常率右侧9%,左侧9%;胫后神经纤维异常率右侧16%,左侧23%;腓总神经纤维异常率右侧28%,左侧29%。感觉神经纤维受损:正中神经纤维异常率右侧63%,左侧49%;尺神经纤维异常率右侧26%,左侧27%;胫后神经纤维异常率右侧70%,左侧67%;腓浅神经纤维异常率右侧67%,左侧61%;腓肠神经异常率右侧50%,左侧47%。DPN组较NDPN组病程更长,血HbA1c、FBG、LDL-C、同型半胱胺酸更高,差异均有统计学意义(P0.05)。结论糖尿病周围神经病变以感觉纤维受损为主,下肢重于上肢,病程、FBG、HbA1c、LDL-C、同型半胱胺酸等为糖尿病周围神经病变的危险因素。

Analysis of electroneurophysiological and correlation factor in 114 patients with type 2 diabetes

Objective To observe the characteristics of electroneurography in type 2 diabetic patients ,and the related risk factors of diabetic peripheral neuropathy. Methods Nerve conduction velocity was measured in 114 patients with type 2 diabe-tes. The age ,course of disease ,fasting blood sugar ,glycosylated hemoglobin ,low-density lipoprotein ,blood pressure and blood homocysteine between patients with diabetic peripheral neuropathy and diabetic patients with normal nerve conduction were compared. Results Ninety-four diabetic peripheral neuropathy and 20 normal nerve conduction in 114 diabetic patients. Motor nerve fibers damage:the erro ratio of median nerve on the right was 31% ,which was 19% on the left ;the erro ratio of ulnar nerve on the right was 9% ,which was 9% on the left;the erro ratio of posterior tibialr nerve on the right was 16% ,which was 23% on the left ;the erro ratio of common peroneal nerve on the right was 28% ,which was 29% on the left. Sensory nerve fi-bers damage:the erro ratio of median nerve on the right was 63% ,which was 49% on the left ;the erro ratio of ulnar nerve on the right was 26% ,which was 27% on the left ;the erro ratio of posterior tibialr nerve on the right was 70% ,which was 67%on the left ;the erro ratio of superfical peroneal nerve on the right was 67% ,which was 61% on the left ;the erro ratio of sural nerve on the right was 50% ,which was 47% on the left. The course of disease ,fasting blood sugar ,glycosylated hemoglobin , low-density lipoprotein ,blood homocysteine in patients of diabetic peripheral neuropathy were higher than normal nerve con-duction diabetic patients. Conclusion The main nervous lesion are sensory fiber ,lower limbs nerve fibers damaged heavier ;course of disease ,fasting blood sugar ,glycosylated hemoglobin ,low-density lipoprotein and blood homocysteine are related risk factors of diabetic peripheral neuropathy.