单纤维肌电图对糖尿病周围神经病变的应用价值

目的探讨单纤维肌电图(SFEMG)对糖尿病周围神经病变(DPN)的应用价值。方法应用SFEMG检测129例DPN患者的优势侧指总伸肌颤抖(jitter)和纤维密度(FD),按常规方法行神经传导速度(NCS)检测。比较SFEMG和NCS的异常检出率,并分析jitter值与血糖化血红蛋白(HbA1C)和预后的关系。结果 SFEMG异常检出率(91.5%)显著高于NCS(78.3%)(P<0.01)。HbA1C轻度升高组SFEMG异常检出率(86.4%)显著高于NCS异常检出率(69.7%)(χ2=7.69,P<0.01),而HbA1C重度升高组差异无统计学意义。jitter值与HbA1C水平呈正相关(r=0.3132,P<0.05)。jitter值正常及轻度异常患者治疗有效率(82.3%)及治愈率(30.6%)均显著高于明显异常者(54.2%,11.9%)(χ2=11.02,P<0.01;χ2=6.32,P<0.05)。结论 SFEMG对DPN的诊断意义显著,并且可用于DPN的预后判断。

Application value of single-fiber electromyography on diabetic peripheral neuropathy

Objective To investigate the application value of single-fiber electromyography(SFEMG) on diabetic peripheral neuropathy(DPN).Methods The values of jitter and fiber density(FD) of extensor digitorum communis muscle in the dominant side in 129 DPN patients were determined by SFEMG.Nerve conduction velocity(NCS) was performed with the routine method.The abnormal detection rate between SFEMG and NCS were compared.The relationship between the values of jitter,the level of glycosylated hemoglobin(HbA1C) and the prognosis were analyzed.Results The abnormal detection rate of SFEMG(91.5%) was significantly higher than NCS(78.3%)(P<0.01).The abnormal detection rate of SFEMG in low increasing HbA1C level group(86.4%) was significantly higher than NCS(69.7%)(χ2=7.69,P<0.01),and there was no significantly difference in high increasing HbA1C level group.There was a positive correlation between the values of jitter and the level of HbA1C(r=0.3132,P<0.05).The effective rate(82.3%) and cure rate(30.6%) in patients with normal or mild abnormal jitter values were significantly higher than the patients with severe abnormal jitter value(54.2%,11.9%)(χ2=11.02,P<0.01;χ2=6.32,P<0.05).Conclusions SFEMG is valuable for the diagnosis,and also can be used for the judgment of DPN prognosis.