感觉神经定量检测在2型糖尿病下肢周围神经损伤中的临床研究  

Clinical research on quantitative sensory testing instrument for early diabetic nerve injury of the lower limbs

作　　者：王天鹭 赵挺洋 赵诚炫[2] 王新宴[2] 徐丽梅[1] 

机构地区：[1]解放军空军总医院中医科,北京100142 [2]解放军空军总医院特诊科,北京100142

出　　处：《中华临床医师杂志（电子版）》2015年第15期24-27,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：首都临床特色应用研究(Z121107001012011)

摘　　要：目的：通过感觉神经定量检测手段，对2型糖尿病患者的下肢神经损伤进行量化评估。方法2型糖尿病患者41例，男32例，女9例，年龄41～86岁，病程1个月至30年，对患者进行感觉神经定量检测。将41例患者按照是否合并血脂异常分为单纯2型糖尿病组16例，2型糖尿病合并血脂异常组25例，采用感觉神经定量检测仪器测定腓肠神经在2000 Hz、250 Hz、5 Hz的电流阈值，并将全部患者按病程≤5年和＞5年分为两组，检测相关数据。结果检测41例2型糖尿病患者，双下肢电流感觉阈值异常的共39例（其中单足神经受损为13例，双足神经受损为26例），正常2例。2型糖尿病合并血脂异常组较单纯2型糖尿病组在5 Hz、250 Hz时CPT升高明显（P＜0.05），2000 Hz时CPT阈值无统计学意义。病程≤5年和＞5年两组腓肠神经在2000 Hz、250 Hz及5 Hz时的CPT阈值无统计学意义（P＞0.05），两组评分无统计学意义（P＞0.05）。结论通过感觉神经定量检测可以发现糖尿病患者在出现明显临床感觉之前已经出现神经受损，一部分患者早期还可出现单足神经受损情况。在糖尿病早期神经病变时，感觉神经定量检测可以早期诊断2型糖尿病患者细的无髓神经纤维受损情况及量化严重程度，以便早期诊治糖尿病周围神经病变。ObjectiveBy the methods of quantitative detection of sensory nerve, clinical study was conducted to quantify assessment for patients with type 2 diabetes lower limb nerve injury.MethodsIn 41 patients with type 2 diabetes melitus, 32 male patients, 9 cases of female, the age ranged from 41 to 86 years old, course of disease was 1 month to 30 years. 41 patients were divided into type 2 diabetes group with 16 patients, type 2 diabetes with dyslipidemia group 25 patients. Using the neurometer, colecting cuttent perception thresholds （CPT） testing at 2 000, 250 and 5 Hz was performed on peroneal nerves, and all the patients according to disease duration less than 5 years and over 5 years were divided into two groups. Biochemical parameters of the groups were tested.ResultsDetected the 41 cases of type 2 diabetes patients, double lower limbs current perception threshold anomaly were a total of 39 cases （the single foot nerve damage in 13 cases, double foot nerve damage in 26 cases）, 2 cases were normal. Compared with type 2 diabetes group, the 250, 5 Hz CPT in type 2 diabetes with dyslipidemia group was significantly higher （P〈0.05）, in the course of disease less than 5 years and more than 5 years of two groups, sural nerve of CPT threshold and score had no statistical significance （P〉0.05）.ConclusionThe result of sensory nerve quantitative detection found the patients had nerve damage before clear clinical sense, a part of patients may also have single foot nerve damage in early stage. Sensory nerve quantitative detection can early diagnose the thin unmyelinated nerve fiber damage and quantifythe severity in type 2 diabetes melitus patients, in the diagnosis of early DPN damage especialy.

关 键 词：糖尿病 周围神经系统疾病 糖尿病足 腓肠神经 感觉神经定量 

分 类 号：R587.2[医药卫生—内分泌]