运动诱发电位对2型糖尿病马尾神经近端损害的诊断价值  

Diagnostic value of motor evoked potential for type 2 diabetes with cauda equina and proximal nerve damage

作　　者：李蕾[1] 张红霞[2] 李清楚[1] 康志强[1] 姜丹[1] 李金凤[2] 宋新光[2] 

机构地区：[1]郑州大学附属郑州中心医院内分泌科,郑州450007 [2]郑州大学附属郑州中心医院神经电生理科,郑州450007

出　　处：《郑州大学学报（医学版）》2016年第3期401-405,共5页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的：探讨运动诱发电位对2型糖尿病马尾神经近端损害的诊断价值。方法：107例2型糖尿病患者分为无周围神经病变组（NDPN组）60例、有周围神经病变组（DPN组）47例,另选正常对照33例,检测指标包括腘窝、S1、T12三点刺激的踇展肌运动诱发电位潜时及波幅,S1-腘窝、T12-腘窝、T12-S1的运动传导速度;并采用logistic回归分析DPN的危险因素。结果：DPN组较NDPN组及对照组的运动诱发电位腘窝刺激的潜时延长,波幅降低;S1刺激的潜时延长,波幅降低;T12刺激的潜时延长,波幅降低;T12-S1传导速度减慢,S1-腘窝传导速度减慢,T12-腘窝传导速度减慢（P〈0.05）。与NDPN组相比,DPN组的年龄、病程、FPG、Hb A_1c升高（P〈0.05）。Logistic回归分析结果显示,年龄（OR=1.079,95%CI=1.032～1.129）、病程（OR=1.099,95%CI=1.019～1.185）、FPG（OR=1.195,95%CI=1.026～1.390）、Hb A_1c（OR=1.416,95%CI=1.113～1.802）为DPN的危险因素。结论：2型糖尿病神经病变存在马尾及周围神经近端损害,年龄、病程、FPG、Hb A_1c是影响DPN的危险因素。Aim： To investigate the diagnostic value of motor evoked potential（ MEP） for type 2 diabetes with cauda equina and proximal nerve damage. Methods： A total of 107 cases of type 2 diabetes were divided into two groups： 60 patients without diabetic peripheral neuropathy（ NDPN group）,47 cases with diabetic peripheral neuropathy（ DPN group）,and 33 normal cases were collected as control group. The detection indexes included latency time and amplitude of hallux abductor＇ s MEP,and movement conduction velocity from S1 to popliteal fossa,from T12 to popliteal fossa,and from T12 to S1,by stimulating popliteal fossa,S1 and T12. Logistic regression analysis was used to explore the risk factors. Results： Compared with the NDPN group and the control group,DPN group induced potential popliteal with a longer latency time,shorter amplitude,S1 with a longer latency time,shorter amplitude,T12 with a longer latency time,shorter amplitude,a lower T12-S1 conduction velocity,a lower S1-popliteal conduction velocity,a lower T12-popliteal conduction velocity（ P 0. 05）. The age,course of disease,FPG and Hb A_1 c of DPN group were significantly increased compared with the NDPN group（ P 0. 05）. Age（ OR = 1. 079,95% CI = 1. 032- 1. 129）,course of disease（ OR = 1. 099,95% CI = 1. 019- 1. 185）,FPG（ OR = 1. 195,95% CI = 1. 026- 1. 390）,and Hb A_1c（ OR = 1. 416,95% CI = 1. 113-1. 802） were the risk factors of DPN. Conclusion： There is a cauda equina and peripheral nerve proximal damage of the type 2 diabetic neuropathy,and age,course of disease,FPG and Hb A_1 c are the risk factors of DPN.

关 键 词：2型糖尿病 马尾 神经近端损害 运动诱发电位 

分 类 号：R587.1[医药卫生—内分泌]