2型糖尿病患者脑干听觉诱发电位改变及其相关因素分析

目的]探讨2型糖尿病患者听力损害的特点及与各临床因素之间的关系.方法]测定132例2型糖尿病患者及40例健康人的脑干听觉诱发电位(BAEP).其中病例组按病程分为病程＜5年(A组)、5年≤病程＜10年(B组)、病程≥10年(C组),分析影响听力的危险因素.结果]①B、C组的Ⅰ、Ⅲ波的潜伏期(PL),Ⅰ~Ⅲ波的峰间潜伏期(IPL)较对照组明显延长,C组的Ⅰ、Ⅲ波的PL,Ⅰ~Ⅲ波的IPL较A组明显延长( P <0.05),左右耳均无明显差异( P >0.05).②A组BAEP异常12例(26.67%),B组BAEP异常16例(35.56%),C组的BAEP异常28例(66.67%),组间差异有统计学意义( P <0.05).③周围神经病变严重组(病变神经数＞4条)的Ⅰ波的PL、Ⅰ~Ⅴ波的IPL较周围神经病变较轻组(病变神经数≤4条)明显延长( P ＜0.05).④病程、糖化血红蛋白是2型糖尿病患者听力损害的危险因素,病程与BAEP的Ⅰ、Ⅲ波的PL呈正的直线相关关系.结论]BAEP是检测糖尿病患者听觉功能异常的有效方法,积极进行听力学检测有助于糖尿病患者听力损害的早期诊断和干预治疗.

Analysis of the Change of BEAP in Type 2 Diabetes Mellitus and Its Related Factors

Objective] To explore the characteristics of hearing impairments in patients with type 2 diabe- tes mellitus and its relation with the clinical factors. Methods] Brain stem auditory evoked potential（BAEP） of 132 patients with type 2 diabetes mellitus（case group） and 40 healthy people（control group） were deter- mined. According to the disease duration, the case group was divided into the group with disease duration less than 5 years（group A）, the group with disease duration between 5 years and 10 years（group B） and the group with disease duration more than 10 years（group C）. The risk factors influencing the hearing were analyzed. Results] The latency period（PL） and interpeak latency（IPL） of wave Ⅰ and Ⅲ in group B and C were obviously longer than those in control group, and those in group C were obviously, longer than those in group A（ P 〈0.05）. There was no significant difference between left ear and right ear（ P 〉0.05）. BAEP was abnormal in 12 patients of group A（26.67%）, 16 patients of group B（35.56%） and 28 patients in group C（66.67%）, and there was significant difference among these groups（ P 〈0.05）. PL and IPL of wave I in severe periph- eral neuropathy group（the number of diseased nerve more than 4） were longer than those in mild peripheral neuropathy group（the number of diseased nerve less than 4） （ P 〈0.05）. Disease duration and glycosylated hemoglobin were the risk factors of hearing impairment in patients with type 2 diabetes mellitus. There was positive linear correlation between disease duration and PL of wave Ⅰ and Ⅲ in BEAP. Conclusion] BAEP is an effective method to detect abnormal auditory function in diabetic patients. Active auditory detection is help- ful for the early diagnosis and intervention of diabetic patients with hearing impairment.