糖调节受损患者神经电生理分析

目的 探讨糖调节受损（IGR）患者神经损害的临床和电生理特点。方法 对40例IGR患者（IGR组）、2型糖尿病患者（T2DM组）40例及30例健康对照者（对照组）进行四肢神经传导检测，对空腹血糖（FBG）、餐后2小时血糖（2 hPBG）、糖化血红蛋白（HbA1c）、血脂、运动及感觉神经传导速度等指标进行分析。结果 与对照组比较，IGR组胫神经感觉神经传导速度（NCV）减慢（P<0.05）；T2DM组各神经NCV均减慢（P<0.05），以胫神经、腓总神经减慢显著（P<0.01）。IGR组和T2DM 组感觉神经传导异常程度重于运动神经，下肢重于上肢（P<0.05）。FBG、2 hPBG、HbA1c水平是IGR患者发生神经传导异常的独立危险因素（P<0.05）。结论 IGR患者早期神经损害在血糖轻微出现异常时已出现，电生理检查有助于早期发现临床病变，可用于IGR患者糖尿病性周围神经病变的早期筛查。

Clinical and neurophysiological features in patients with impaired glucose regulation

Objective To study the clinical and electrophysiological features in patients with impaired glucose regulation(IGR). Methods Motor nerve conduciton velocity(MCV) and Sensory nerve conduciton velocity(NCV) were performed in 40 IGR patients (IGR group), 40 diabetes mellitus patients (T2DM group) and 30 controls (control group). The fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin (HbA1c) and the blood lipid were analyzed.Results Compared with the control group, NCV of the tibial nerves in IGR group was significantly slower（P<0.05）. NCV in T2DM group of every nerve was significantly slower（P<0.05）, and was significantly slower in the tibial nerves and peroneal nevers（P<0.01）. More severe abnormal never conduction was found in lower limbs than in upper limbs in IGR group and T2DM group. The abnormal degree was more severe in sensory nerve than in motor never（P<0.05）. Diabetic peripheral neuropathy is associated with FBG, 2 hPBG and HbA1c in patients with IGR. Conclusion The most common clinical and electrophysiological manifestation of diabetic neuropathy is sensory disturbance, which is more severe in lower limbs. Subclinical diabetic peripheral neuropathy in IGR patients can be detected by electrophysiological examination which is useful to verify the range and extent of the nerve lesion involved in the early stage of diabetic peripheral neuropathy.