神经传导速度对糖尿病痛性周围神经病的诊断价值  

Clinical Application of Nerve Conductive Velocity in Painful Diabetic Peripheral Neuropathy

作　　者：时霄冰[1] 于生元[2] 杨爱民[1] 姜磊[1] 

机构地区：[1]解放军总医院南楼神经内科,北京100853 [2]解放军总医院神经内科,北京100853

出　　处：《现代生物医学进展》2013年第6期1108-1110,共3页Progress in Modern Biomedicine

基　　金：解放军总医院科技创新苗圃基金项目(10KMM25)

摘　　要：目的:探讨糖尿病痛性周围神经病的神经传导特点及神经传导速度在糖尿病痛性周围神经病中的诊断价值。方法:对18例痛性周围神经病患者进行病史采集及神经系统查体。采用肌电诱发电位仪,测定患者的正中神经、尺神经、胫神经、腓总神经及腓肠神经的运动感觉神经传导速度。结果:18例患者中男性13例,女性5例。年龄40-89岁。主要表现为双足烧灼样、针刺样、过电样疼痛。神经系统查体:针刺觉减弱7例,痛觉过敏3例,音叉震动觉减弱12例,跟腱反射减弱/消失15例。18例患者中有14例神经传导速度检查结果异常,腓肠神经感觉神经检查结果异常率高,83.3%,对诊断有帮助。结论:糖尿病痛性周围神经病变出现疼痛症状时已经存在大纤维受累,故神经传导速度异常阳性率高。神经传导速度不能早期发现糖尿病痛性周围神经病,探索一种简单易行的早期筛查方法意义重大。Objective： To investigate the clinical manifestations of painful diabetic peripheral neuropathy （pDPN）and the diagnos-tic value of nerve conductive velocity （NCV）. Methods： Clinical data of 18 cases ofpDPN were studied and NCV was performed in all the patients. Results： All patients presented burning pain or prick pain in the lower limbs. Neurologic examination revealed hypoalgesia in 7 patients and hyperalgesia in 3 patients in a stocking distribution. 12 patients demonstrated decreased vibration sense, and 15 patients had disappeared or decreased Achilles tendon reflex. NCV were performed in all the patients, and the results were abnormal in 14 pa-tients. The abnormal rate of NCV of sural nerve was as high as 83.3 %, which is helpful for the diagnosis. Conclusion： Big fiber damages had already been present when pain appeared and that is why NCV abnormal rate was high. NCV is disable to detect pDPN in the early periods, thus it is important to seek a simple and easy way for early screening.

关 键 词：糖尿病痛性周围神经病 临床特点 神经传导速度 

分 类 号：R587.1[医药卫生—内分泌]