摘要
目的探究早期神经肌电图、震动感觉阈值测定及双下肢血管彩超检查对2型糖尿病周围神经病变患者的临床诊断价值。方法选择2017年1月至2020年10月于珠海市第五人民医院内分泌科就诊的140例2型糖尿病患者作为研究对象(观察组),根据神经肌电图检测结果将其分为神经病变组44例和非神经病变组96例,同时选取同期于本院进行体检的100例健康志愿者纳入对照组。观察组患者于糖尿病确诊后7 d内行神经肌电图检测、震动感觉阈值测定和双下肢血管彩超检查,对照组志愿者于同意参与研究后7 d内进行上述检查。比较三组受检者的神经肌电图传导速度、下肢震动感觉阈值及血管内中膜厚度。结果观察组患者经神经肌电图检测、震动感觉阈值检测和双下肢血管彩超检查,结果显示,存在周围神经病变者分别为44例(31.43%)、47例(33.57%)和46例(32.86%),三种检测方法的检出率比较差异无统计学意义(P>0.05);神经病变组患者的正中神经运动传导速度为(43.85±2.06)m/s,明显快于非神经病变组的(50.67±2.75)m/s和对照组的(54.36±2.46)m/s,差异均具有统计学意义(P<0.05);神经病变组患者的正中神经感觉传导速度为(39.64±2.46)m/s,明显快于非神经病变组的(44.81±2.23)m/s和对照组的(56.52±2.47)m/s,差异均具有统计学意义(P<0.05);神经病变组患者的第一足趾震动感觉阈值为(15.65±1.26)V,明显高于非神经病变组的(10.97±0.83)V和对照组的(6.25±0.34)V,差异均具有统计学意义(P<0.05);神经病变组患者的内中膜厚度为(1.39±0.15)mm,明显厚于非神经病变组的(1.18±0.16)mm和对照组的(0.92±0.23)mm,差异均具有统计学意义(P<0.05)。结论2型糖尿病早期周围神经病变患者的周围神经功能已出现一定程度的病理损害,震动感觉阈值测定及双下肢血管彩超检查均具有与神经肌电图相当的诊断价值,综合运用可对患者的神经病变情况作出更加全面的判断。
Objective To explore the clinical diagnostic value of early neuroelectromyography,vibration sensory threshold measurement,and color Doppler ultrasound examination of lower limbs in patients with type 2 diabetic peripheral neuropathy.Methods A total of 140 patients with type 2 diabetes treated in the Department of Endocrinology in the Fifth People's Hospital of Zhuhai from January 2017 to October 2020 were selected as the research objects(observation group).According to the results of neuroelectromyography,they were divided into neuropathy sub group(n=44)and nonneuropathy sub group(n=96).At the same time,100 healthy volunteers who underwent physical examination in our hospital during the same period were selected into the control group.The observation group underwent neuroelectromyography,vibration sensory threshold measurement,and color Doppler ultrasound examination within 7 days after the diagnosis of diabetes,and volunteers in the control group underwent the above examination within 7 days after agreeing to participate in the study.The neuroEMG conduction velocity,lower limb vibration sensory threshold,and vascular intimamedia thickness of the three groups were compared.Results The observation group were examined by neuroelectromyography,vibration sensory threshold,and color Doppler ultrasound examination of blood vessels of lower limbs,and results showed that there were 44 cases(31.43%),47 cases(33.57%),and 46 cases(32.86%)of peripheral neuropathy,with no statistically significant difference among the detection rate of the three detection methods(P>0.05).The median nerve motor conduction velocity in the neuropathy subgroup was(43.85±2.06)m/s,which was significantly faster than(50.67±2.75)m/s and(54.36±2.46)m/s of the nonneuropathy subgroup and the control group(P<0.05).The median nerve sensory conduction velocity in the neuropathy subgroup was(39.64±2.46)m/s,which was significantly faster than(44.81±2.23)m/s of the nonneuropathy subgroup and(56.52±2.47)m/s of the control group(P<0.05).The first toe vibration sensation threshold of the neuropathy subgroup was(15.65±1.26)V,which was significantly higher than(10.97±0.83)V of the nonneuropathy subgroup and(6.25±0.34)V of the control group(P<0.05).The intimamedia thickness of the neuropathy subgroup was(1.39±0.15)mm,which was significantly thicker than(1.18±0.16)mm of the nonneuropathy subgroup and(0.92±0.23)mm of the control group(P<0.05).Conclusion Peripheral nerve function of patients with early peripheral neuropathy has shown a certain degree of pathological damage,and vibration sensory threshold measurement and vascular color ultrasound examination of both lower limbs have comparable diagnostic value to neuroelectromyography.The comprehensive application can make a more comprehensive judgment of the patient's neuropathy.
作者
刘强
梁健
陈燕
LIU Qiang;LIANG Jian;CHEN Yan(Department of Endocrinology,the Fifth People's Hospital of Zhuhai,Zhuhai 519000,Guangdong,CHINA)
出处
《海南医学》
CAS
2021年第15期1950-1954,共5页
Hainan Medical Journal
关键词
2型糖尿病
周围神经病变
神经肌电图
震动感觉阈值
彩超
诊断
Type 2 diabetes
Peripheral neuropathy
Neuroelectromyography
Vibration perception threshold
Color Doppler ultrasound
Diagnosis
