糖尿病性周围神经病变程度与神经传导速度及其血浆糖化血红蛋白水平的关系  

Correlations of diabetic peripheral neuropathy with nerve conduction velocity and plasma glycosylated hemoglobin

作　　者：向丽[1] 张巧俊[1] 王俊宏[2] 高蕊[1] 赵英贤[1] 

机构地区：[1]西安交通大学第二医院神经内科,陕西省西安市710004 [2]西安交通大学第二医院内分泌科,陕西省西安市710004

出　　处：《中国临床康复》2004年第27期5840-5841,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:了解电生理检查在糖尿病性周围神经病(diabeticperipheralneu-ropathy,DPN)中的评估价值及DPN的相关危险因素。方法:测定104例2型糖尿病患者周围神经运动传导速度(motornerveconductionvelocity,MCV)和感觉传导速度(sensorynerveconductionve-locity,SCV),并与临床症状、体征及病程和糖化血红蛋白进行相关分析研究。结果:104例2型糖尿病患者中有神经系统异常症状或体征者48例占46.2%,MCV异常者79例占76.0%,SCV异常者96例占92.4%。与正常值相比犤潜伏期:腓总神经为(3.77±0.98)ms,胫神经为(5.0±0.5)ms,腓肠神经为(3.07±0.28)ms;MCV:腓总神经为(47.3±3.9)m/s,胫神经为(42.9±4.9)m/s,SCV:腓肠神经为(33.9±3.25)m/s〗,2型糖尿病患者周围神经末端潜伏期明显延长犤腓总神经为(5.27±1.33)ms,胫神经为(6.14±1.25)ms,腓肠神经为(4.98±0.67)ms犦,MCV和SCV明显减慢犤腓总神经MCV为(36.43±7.28)m/s,胫神经MCV为(36.07±8.82)m/s,腓肠神经SCV为(22.87±4.12)m/s犦,均具有显著性差异(t=4.231～7.513,P<0.01)。2型糖尿病患者病程越长周围神经MCV和SCV异常率越高,周围神经传导速度与血浆糖化血红蛋白值负相关(r=-0.802,P<0.01)。结论:糖尿病性周围神经病变的感觉神经异常明显于运动神经,且病程越长、糖化?AIM:To investigate the evaluated value of electrophysiological examinations on diabetic peripheral neuropathy(DPN) and related dangerous factors to DPN. METHODS:The peripheral nerve motor conduction velocity(MCV) and sensory nerve conduction velocity(SCV) of 104 patients with type 2 diabetes mellitus were investigated,and the relation between nerve conduction velocities and the related factors,such as dinical symptoms,physical signs,courses and the level of glycosylated hemoglobin ALC(HbAIC) was analyzed. RESULTS:Among the 104 cases,the abnormality rate of nervous system was 46.2%(48 cases),including 76.0%(79 cases) of MCV,and 92.4%(96 cases) of SCV.Compared with the normal[latent period: common peroneal nerve(3.77±0.98) ms,tibial(5.0±0.5)ms,sural nerve(3.07±0.28) ms;MCV:common peroneal nerve(47.3±3.9)m/s,tibial(42.9±4.9)m/s,SCV:sural nerve(33.9±3.25)m/s] ,the latent period of type 2 diabetes mellitus peripheral nerve was obviously longer[common peroneal nerve(5.27 ±1.33) ms,tibial(6.14±1.25)ms,sural nerve(4.98±0.67) ms],MCV and SCV were obviously slow[common peroneal nerve(36.43±7.28) m/s,tibial(36.07±8.82)m/s,sural nerve SCV(22.87±4.12) m/s],all had significant differences(t=4.231 to 7.513,P< 0.01). Both MCV and SCV of peripheral nerve were negatively related with course,and HbAIC,as well. CONCLUSION:The peripheral nerve lesion is more serious in sensory nerve than in motor nerve,the longer the course,the higher the level of HbAIC and blood sugar,the slower the peripheral nerve conduction velocity,the more serious the peripheral nerve lesion.

关 键 词：糖尿病 非胰岛素依赖型 血红蛋白A 糖基化 神经传导 

分 类 号：R587.1[医药卫生—内分泌]