电流感觉阈值测试在2型糖尿病小纤维神经病变的早期诊断价值  

The early diagnostic value of current perception threshold for small fiber neuropathy in patients with type 2 diabetes mellitus

作　　者：潘晓丽[1] 叶红莲[1] 冯雪梅[1] 

机构地区：[1]中国医科大学附属盛京医院神经功能检查室,110004

出　　处：《中国神经免疫学和神经病学杂志》2016年第6期398-402,共5页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨电流感觉阈值测试(current perception threshold,CPT)在2型糖尿病小纤维神经病变中的早期诊断价值。方法选择临床确诊的2型糖尿病患者99例,应用肌电图仪常规法进行双侧正中神经、双侧腓浅神经感觉神经传导速度检测,应用感觉神经定量检测仪进行双正中神经、双腓浅神经CPT测定,电流刺激频率分别为2000Hz、250Hz、5Hz,比较CPT及SCV两种指标的异常率;依患者有、无自觉症状分为两组,依病程<5年(45例)、5年≤病程<10年(32例)及病程≥10年(22例)分为三组,分别比较双侧正中神经、双侧腓浅神经不同频率刺激CPT值及SCV。结果双正中神经、双腓浅神经CPT异常率明显高于SCV异常率(P<0.05、P<0.01)。与无症状组比较,有症状组患者左侧正中神经与双侧腓浅神经的SCV均明显减慢(均P<0.05),双侧正中神经与双侧腓浅神经2000Hz刺激时CPT值均明显增高(均P<0.05),250Hz和5Hz时CPT值两组间比较差异无统计学意义(均P>0.05)。双正中神经、双腓浅神经的不同频率CPT阈值及SCV在不同病程组间差异均无统计学意义(均P>0.05)。结论 CPT在糖尿病小纤维神经病变早期诊断中具有一定价值。联合神经传导速度测定可能提高糖尿病神经病变的诊断率。Objective To evaluate the early diagnostic value of current perception threshold（CPT）for small fiber neuropathy（SFN）in patients with type 2diabetes mellitus（DM）.Methods Ninety-nine patients with type 2DM were enrolled in this study.The bilateral median nerve and superficial peroneal nerve sensory nerve conduction velocity（SCV）and CPT were detected by routine electromyograph（EMG）and the neurometer at 2000 Hz,250Hz and 5Hz in all cases.The abnormity rates were compared between CPT and SCV at different frequencies.The patients were divided into 2groups according to the subjective symptoms and were divided into three subgroups according to the course duration,5years group（45cases）,5 ≤ duration 10years group（32cases）,≥ 10 years group（22cases）.CPT and SCV of the bilateral median nerve and superficial peroneal nerve were compared between the different frequencies.Results The abnormal rate of CPT in the bilateral median nerve and superficial peroneal nerve was significantly higher than that of the SCV（P〈0.05 or P〈0.01,respectively）.Compared with the asymptomatic group,SCV of the left median nerve and bilateral superficial peroneal nerve decreased significantly in the symptomatic group（P〈0.05,respecyively）,and the CPT value of the bilateral median nerve and superficial peroneal nerve at 2000 Hz also increased significantly（P〉0.05,respecyively）.But there were not significant changes between the groups of CPT values at 250 Hz and 5Hz（P〈0.05,respecyively）.There were not significant differences of CPT value at different frequencies and SCV between different course groups（P〉0.05,respecyively）.Conclusions CPT has a certain value in the early diagnosis for SFN in patients with type 2 DM.CPT combined with SCV could improve the diagnosis rate of diabetic neuropathy.

关 键 词：2型糖尿病 小纤维神经病变 电流感觉阈值测定 感觉神经传导速度测定 

分 类 号：R747.8[医药卫生—神经病学与精神病学]