230例糖尿病周围神经病变的电生理分析

目的探讨神经传导速度（NCV）、F波及H反射对糖尿病周围神经病变（DPN）的诊断价值。方法用Viking Select肌电图诱发电位仪对230例2型糖尿病患者行正中神经、尺神经、胫神经、腓总神经运动传导速度（MCV）检测和正中神经、尺神经、腓肠神经感觉传导速度（SCV）检测与胫神经H反射检测及胫神经F波检测。结果230例糖尿病患者的SCV异常率62．2％，MCV异常率52．6％，SCV和MCV异常率差异有统计学意义（P〈0．05）；胫神经F波异常率53．9％，H反射异常率70．9％，H反射异常率和F波异常率差异有统计学意义（P〈0．05）。上肢共检测神经1840条，927条异常，异常率50．4％；下肢检测神经1380条，891条异常，异常率64．6％；上下肢传导速度异常率相比，差异有统计学意义（P〈0．05）。结论NCV及F波、H反射是早期发现糖尿病周围神经病变的有效手段，其中H反射是最敏感的指标。

Eiectrophysiological analysis of 230 patients with diabetic peripheral neuropathy

Objective To observe the diagnostic value of nerve conduction velocity,F wave and H-reflex in patients with diabetic peripheral neuropathy.Methods Nerve conduction velocity,F wave and H-reflex were examined in 230 patients with diabetic peripheral neuropathy.MCV of the madian,ulnar,peronea and tibial nerves were measured;SCV of the madian,ulnar and sural nerves were measured and tibial H-reflex and F wave were elicited by electromyography.The consequence was analyzed.Results The abnormal rate of SCV was 62.2%,the abnormal rate of MCV was 52.2%,significant difference were found between SCV and MCV(P < 0.05).The abnormal rate of F wave was 53.9%,the abnormal rate of H-reflex was 70.9%,significant difference were found between F wave and H-reflex(P < 0.05).The abnormal rate of lower limb was higher than that of upper limb(P < 0.05).Conclusion NCV,F wave,H-reflex might be more reliable and sensitive diagnostic measures for early diabetic peripheral neuropathy,and H-reflex is most sensitive.