早期糖尿病周围神经及自主神经病变的神经肌电图分析  

Neural electromyography analysis of peripheral and autonomic neuropathy in early diabetes mellitus

作　　者：郑兴敏[1] 蔡继勇[1] 黄辉海[1] 

机构地区：[1]福建医科大学附属福州市第一医院神经内科,350009

出　　处：《中国实用医药》2015年第19期27-29,共3页China Practical Medicine

摘　　要：目的探讨几种神经肌电图检测方法在早期糖尿病患者诊断周围神经损害中的敏感性。方法对164例病程<5年的糖尿病患者的正中神经、腓总神经、胫神经运动神经传导速度(MCV)与正中、腓浅、腓肠感觉神经传导速度(SCV)、正中神经F波、胫神经H反射及交感神经皮肤反应(SSR)采用神经电生理方法进行测定。结果 164例患者胫神经的H反射及下肢SSR总异常率均较高,且异常率随病程的增加而增加;病程>3年的糖尿病患者双下肢腓总神经MCV与腓浅神经SCV异常率也很可观。结论胫神经H反射是糖尿病早期周围神经病变最敏感指标,SSR的异常亦不可忽视,要综合神经肌电图几项检查结果 ,正确评价糖尿病周围神经功能状态。Objective To investigate sensibility of several neural electromyography methods for peripheral and autonomic neuropathy in early diabetes mellitus. Methods Nerve electrophysiology method was applied for detection of motor nerve conduction velocity（MCV） in median nerve, nervus peroneus communis and tibial nerve, sensory nerve conduction velocity（SCV） in median nerve, superficial peroneal nerve and calf, median nerve F wave, tibial nerve H reflection and sympathetic skin response（SSR） in 164 patients with diabetes mellitus 5 years. Results The 164 cases had higher total abnormality rates of tibial nerve H reflection and lower limb SSR, and the abnormality rates increased along with disease course. Diabetes mellitus patients 3 years had high abnormality rates of double lower limbs common peroneal nerve MCV and superficial peroneal nerve SCV. Conclusion Tibial nerve H reflection is the most sensitive indicator for diabetic early peripheral neuropathy, along with abnormality of SSR. Comprehensive consideration of several neural electromyography results is necessary for correct diagnosis of diabetic peripheral nerve function status.

关 键 词：神经肌电图 早期糖尿病 糖尿病周围神经病 交感神经皮肤反应 

分 类 号：R587.2[医药卫生—内分泌]