感觉电流阈值评估2型糖尿病神经纤维损伤的应用研究  

The application of current perception threshold in evaluating the diabetic nerve fiber damage

作　　者：赵仁华[1] 牛奔[1] 苏恒[1] 薛元明[1] 唐清丽 

机构地区：[1]云南省第一人民医院内分泌科,昆明650032

出　　处：《中国糖尿病杂志》2015年第7期598-601,共4页Chinese Journal of Diabetes

基　　金：云南省卫生科技内设研究机构项目(2011ws0011);大理学院2013年医学专项教改立项项目(DLJGKHN2013001)

摘　　要：目的探讨感觉电流阈值(CPT)评估T2DM患者感觉神经纤维损伤的价值。方法选取T2DM患者218例,根据有无神经系统症状,分为有症状组和无症状组,各109例。采用感觉神经定量检测仪对感觉神经纤维功能进行2000Hz、250Hz、5Hz 3种不同强度的客观测试,比较不同部位不同强度刺激下的CPT。结果有症状组CPT异常者多于无症状组[96(88.1%)vs 51(46.8%),P<0.01];两组不同部位不同强度的CPT比较,差异有统计学意义(P<0.05);有症状组中,有麻木症状(麻木亚组)者40.4%,有刺痛症状(刺痛亚组)者13.8%,既有麻木又有刺痛症状(麻木+刺痛亚组)者43.1%。麻木亚组主要以2000Hz损伤为主,刺痛亚组、麻木+刺痛亚组主要以2000Hz和250Hz损伤为主。结论糖尿病患者有神经系统症状时,不同强度刺激下粗有髓鞘神经纤维(Aβ)、细有髓鞘神经纤维(Aδ)和无髓鞘神经纤维均受损,以Aβ和Aδ纤维损伤最为明显。Objective To investigate the value of current perception threshold（CPT）in evaluating the diabetic sensory nerve fiber damage. Methods 218 patients with type 2diabetes（T2DM）were divided into two groups named symptomatic group（n=109）and asymptomatic group（n=109）.Quantitative sensory nerve detector was used to test the CPT of different parts of the body at different degrees of stimulation（2000 Hz,250 Hz and 5 Hz）. Results The proportion with abnormal CPT in symptomatic group（88.1%）was higher than that in asymptomatic group（46.8%）（P〈0.01）.The CPT of different parts at various degrees of stimulation between two groups had significant difference（P〈0.05）.In symptomatic group,40.4% presented with numbness（numbness subgroup）,13.8% with tingling（tingling subgroup）,and 43.1% with both numbness and tingling symptoms（numbness ＋tingling subgroup）.Damage of sensory nerve fiber in numbness subgroup mainly occurred at 2000 Hz,and in tingling subgroup and numbness＋tingling subgroup at 2000 Hz and 250 Hz. Conclusion The CPT of different degrees of stimulation showed that the coarse,fine and nonmyelinated nerve fibers were all damaged in T2 DM patients with neurological symptoms,especially in Aβand Aδnerve fibers.

关 键 词：糖尿病 2型 神经纤维 感觉电流阈值 

分 类 号：R587.2[医药卫生—内分泌]