电流感觉阈值对糖尿病足风险的预测研究

目的应用感觉神经定量检测仪检测糖尿病足患者周围感觉神经,探讨电流感觉阈值(CPT)在糖尿病足发生风险的预测价值。方法测定48例糖尿病足(糖尿病足组)及212例未合并足病的糖尿病患者(非糖尿病足组)的正中神经、腓肠神经于2000Hz、250Hz、5Hz的CPT,并检测患者踝肱指数(ABI)及血糖等代谢指标,记录高血压、冠心病等病史及糖尿病并发症情况。结果与非糖尿病足组患者比较,糖尿病足组患者CPT明显升高,其中5Hz(P<0.01)最为明显;糖尿病足组合并高血压、冠心病、脑梗死、糖尿病肾病、糖尿病视网膜病变的发生率均高于非糖尿病足组(P<0.01);糖尿病足组较非糖尿病足组ABI明显降低,在各分度组差异均有统计学意义(P<0.01)。ABI与5HzCPT及250HzCPT均呈负相关(r=-0.454,P<0.01;r=-0.342,P<0.05)。结论糖尿病神经病变的发生与血管病变有关,ABI低、CPT高的患者糖尿病足较单独ABI低的患者糖尿病足发生风险增加,CPT联合ABI较单独检测ABI对于糖尿病足的发生更加有预测价值。

Current perception threshold in the prognosis of diabetic foot

Objective To investigate the clinical value of current perception threshold(CPT) examination in screening diabetic peripheral neuropathy in type 2 diabetes mellitus(DM) patients with diabetic foot using the neurometer.Methods Forty-eight DM patients with diabetic foot(diabetic foot group) and 212 DM patients without diabetic foot(pure DM group) were involved in the study.Using the neurometer,CPT testing at 2000,250 and 5 Hz was performed on median and peroneal nerves.Ankle branchial index(ABI) and metabolic index such as plasma glucose were taken on these patients.The history of past illnesses such as hypertension or coronary artery disease and diabetic complications were recorded.Results Compared with patients in pure DM group,the CPT in diabetic foot group was significantly higher,especially at low frequency(5 Hz,P <0.01).The prevalence of hypertension,coronary artery disease,brain infarction,diabetic nephropathy was significantly higher,too.The ABI was significantly lower in different degree groups in diabetic foot group than that in pure DM group.There was a significantly negative correlation between the the CPT and the ABI(5 Hz:r=-0.454,P <0.01.25 Hz:r=-0.342,P < 0.05).Coclusions The diabetic patients who had higher CPT and lower ABI were more likely to become paitents with diabetic foot.ABI,combined with CPT examination could detect more patients with diabetic neuropathy and those at risk for diabetic foot than ABI examination alone.