单纤维肌电图对糖尿病周围神经病及糖尿病肾病的早期诊断价值  

The value of single fiber electromyography in the early diagnosis of diabetic peripheral neuropathy and diabetic nephropathy

作　　者：张永葆[1] 朱天宝[1] 缪世盼 张欢[1] 王卫华[1] 祝善尧[1] 

机构地区：[1]安徽医科大学附属巢湖医院神经内科,安徽合肥238000

出　　处：《中国实用神经疾病杂志》2017年第21期52-55,共4页Chinese Journal of Practical Nervous Diseases

基　　金：2014年度安医大附属巢湖医院培育基金

摘　　要：目的探讨单纤维肌电图(SFEMG)对糖尿病周围神经病(DPN)及糖尿病肾病的早期诊断价值。方法应用SFEMG对43例2型糖尿病患者行指总伸肌的颤抖(jitter)和纤维密度(FD)测定,同时检测神经传导速度(NCV),并测空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血脂、同型半胱氨酸(Hcy)及尿微量白蛋白/尿肌酐比值(UACR)。比较SFEMG和NCV的异常检出率,并分析颤抖和FD与病程、LDL-C、HbA1c、Hcy、UACR的相关性。结果全部患者颤抖、FD和NCV的异常检出率分别为65.1%、53.5%和48.8%,24例无DPN症状患者分别检出9例(20.9%)、4例(9.3%)和2例(4.7%)。颤抖和FD呈正相关,且均与病程、LDL-C、HbA1c、Hcy和UACR呈正相关。结论 SFEMG是DPN的早期诊断指标,SFEMG异常者行HbA1c、Hcy和UACR联合检测对DPN和糖尿病肾病的早期诊治有帮助。Objective To investigate the value of single fiber electromyography （SFEMG） in the early diagnosis of diabetic peripheral neuropathy （DPN）. Methyls Forty-three patients with type 2 diabetes were enrolled to measure jitter （shivering refers to total extensor） and fiber density （FD） with the nerve conduction velocity （NCV）. Furthermore, the fasting blood glucose （FBG）, glycosylated hemoglobin （HbAlc）, blood Iipids, homocysteine （Hcy） and urine microalbuminuria/creatinine ratio （UACR） were detected either. The abnormal rates of SFEMG and NCV were compared, and the correlations between the parame ters of SFEMG （jitter and FD） and disease duration and serum levels of LDL-C, HbA1c, Hey and UACR were analyzed. Results The abnormal rates of jitter, FD and NCV were 65.1%, 53.5% and 48.8%, respectively. In the 24 asymptomatic patients, the numbers of patients found abnormal jitter, FD and NCV were 9 （20.9 %）, 4 （9.3%） and 2 （4.7 %）, respectively. Jitter and FD had a positive correlation,and both positively correlated with the disease duration and serum levels of LDL-C, HbAlc, Hcy and UACR. Conclusion SFEMG is an early diagnostic indicator of DPN. SFEMG abnormalities, combined with detections of HbAlc, Hcy and UACR,may be helpful for the early diagnosis of DPN and diabetic nephropathy.

关 键 词：单纤维肌电图 糖尿病周围神经病 糖尿病肾病 同型半胱氨酸 尿微量白蛋白/尿肌酐比值 颤抖 纤维密度 神 经传导速度 

分 类 号：R587.2[医药卫生—内分泌]