神经肌电图在合并周围神经病变的Ⅱ型糖尿病患者中的意义  

The meaning of EMG in the diagnosis of typeⅡ diabetes with peripheral neuropathy

作　　者：郭晓贤[1] 高焱[1] 范百亚 康静[1] 贺亚龙[1] 强彩芹 

机构地区：[1]陕西省延安市人民医院神经内科,延安716000

出　　处：《立体定向和功能性神经外科杂志》2014年第3期148-151,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的主要探讨的是神经肌电图在Ⅱ型糖尿病患者周围神经病变的早期诊断中的价值。方法分析2011年7月至2014年1月在我院治疗的Ⅱ型糖尿病患者的临床资料。入组的Ⅱ型糖尿病患者根据患者的病程进行分组,包括A组（病程〉10年）、B组（病程1-10年）和C组（病程〈1年）。比较三组患者的临床资料,正中、尺神经、腓总神经的MCV（运动传导速度）,SCV（感觉传导速度）以及胫神经H反射和尺神经f波的情况。结果本研究共纳入研究对象180例,其中A组57例,B组65例,C组58例。三组患者的正中神经（χ2=9.104,P=0.011）、尺神经（χ2=9.335,P=0.009）、腓总神经（χ2=9.898,P=0.007）的MCV异常比例均存在着显著的差异,且病程越长,异常率越高;三组患者的正中神经（χ2=13.44,P=0.001）、尺神经（χ2=13.56,P=0.001）、腓总神经（χ2=24.09,P=0.000）的SCV异常比例均存在着显著的差异,病程越长,异常率越高;三组患者胫神经H反射异常比例存在显著的差异（χ2=19.12,P=0.000）,且病程越长,异常率越高。而尺神经F波异常比例并无统计学差异（χ2=3.152,P=0.207）。结论Ⅱ型糖尿病患者的病程越长,相应的尺神经、正中神经、腓总神经的MCV、SCV中的异常比例,以及胫神经的H反射异常检出率越高。结合尺神经F波可早期客观检测到糖尿病周围神经病神经近端损害,提高早期诊断。Objective Our retrospective study was aimed to analyze the meaning of EMG in the diagnosis of type 2diabetes with peripheral neuropathy.Methods Clinical data of typeⅡ diabetes patients with peripheral neuropathy received treatment at our hospital from 2011 to 2014was retrospectively analyzed.Patients included were divided into three groups according to the treatment,group A（duration over10years）,group B（duration 1to 10years）and group C（duration less than 1year）.The EMG results of patients in the three groups including MCV,SCV,tibial nerve H reflex and ulnar nerve f wave was analyzed.Results A total of 180 patients were retrospective analyzed,including 57 in group A,65 in group B and 58 in group C.The proportion of abnormal MCV,SCV of median nerve,ulnar nerve and peroneal nerve in three groups was significant different.The longer the duration,the higher the rate of abnormal.There are significant differences between the three groups of patients the proportion of tibial nerve H reflex abnormalities,and the longer the duration,the higher the rate of abnormal.The ulnar nerve f-wave abnormalities had no statistically significant difference.Conclusion The longer duration of typeⅡ diabetes was,the abnormal rate of MCV,SCV of the ulnar nerve,median nerve,peroneal nerve and H reflex of tibial nerve was the higher The detection combined wieh ulnarherve Waves Conld detelt the proximal nerve damage of diabetic periheval neuropatnt in the early peviod and improve ciagnosis.

关 键 词：神经肌电图 周围神经病变 Ⅱ型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]