交感神经皮肤反应与神经传导速度对糖尿病周围神经病变的诊断价值  

Diagnostic value of sympathetic skin response and nerve conduction measurement in diabetic peripheral neuropathy

作　　者：郭晓贤[1] 郝美美[1] 贺亚龙[1] 马世红[1] 范百亚 高焱[1] 康静[1] 

机构地区：[1]陕西省延安市人民医院,延安716000

出　　处：《内科急危重症杂志》2017年第3期207-208,236,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:分析交感神经皮肤反应(SSR)与神经传导速度(NCV)对糖尿病周围神经病变(DPN)的诊断价值。方法:选取43例2型糖尿病患者和43例健康体检者,同时行神经电图检测,包括感觉神经传导速度(SCV)、运动神经传导速度(MCV)和交感神经皮肤反应(SSR),并进行统计学分析。结果:糖尿病组的正中神经、尺神经、腓总神经、胫神经的MCV和正中神经、尺神经、腓肠神经、腓浅神经的SCV均明显低于健康组(均P<0.01);健康组上下肢的起始潜伏期均明显短于糖尿病组(均P<0.01),但糖尿病组上下肢的波幅与健康组比较,差异有统计学意义(P<0.01);糖尿病组患者下肢NCV和SSR的异常率均明显高于上肢(34.8%vs 18.9%,55.7%vs 35.2%,均P<0.01);SSR总异常率显著高于NCV(45.5%vs 24.2%,P<0.01)。结论:NCV和SSR可为DPN的早期诊断提供重要依据,且SSR敏感性更高。Objective： To analyze the diagnostic value of sympathetic skin response（ SSR） and nerve conduction velocity（ NCV） in diabetic peripheral neuropathy（ DPN）. Methods： The electroneurophysiological data of 43 cases of type 2 diabetes and 43 cases of healthy volunteers,including sensory nerve conduction velocity（ SCV）,motor nerve conduction velocity（ MCV） and SSR,were analyzed retrospectively. Results： The MCV of median nerve,ulnar nerve and nervous peroneus communis,and the SCV of median nerve,ulnar nerve and sural nerve in diabetes mellitus group were significantly lower than in the control group（ P 〈 0. 01）. The upper and lower extremities initial incubation period in the diabetes mellitus group was significantly longer than that in the control group（ P 〈 0. 01）. There was no significant difference in amplitude between two groups（ P 〉 0. 01）. The abnormal rate of NCV of lower limbs in patients with diabetes mellitus was significantly higher than that of upper limbs（ 34. 8% vs 18. 9%,P 〈 0. 01）. The abnormal rate of SSR of upper limbs was significantly lower than that of the lower limbs（ 35. 2% vs 55. 7%,P 〈 0. 01）. The total abnormal rate of SSR was significantly higher than that of NCV（ 45. 5% vs 24. 2%,P 〈 0. 01）. Conclusion： NCV and SSR are sensitive indices for the diagnosis of DPN,and can provide important evidence for the early diagnosis. SSR could be more sensitive to early diagnosis of DPN.

关 键 词：2型糖尿病 糖尿病周围神经病变 交感神经皮肤反应 运动神经传导速度 感觉神经传导速度 诊断 

分 类 号：R587.2[医药卫生—内分泌]