比较分析F波检测在糖尿病周围神经病变电生理检查中的价值  

Comparing and analyzing the application value of F wave in the use of electrophysiologicalexamination of diabetic peripheral neuropathyWei, Wang Dan, Liu Jingsong, Li Xue, He Wei, Sun Liyan. Department of Neurology, Xinhua Hospital Affiliated to Dalian University, Dalian 116021, China

作　　者：孙庆权 赵蒙[1] 殷宏宇[1] 王为[1] 王丹[1] 刘京松 李雪 何伟 孙丽艳[1] 

机构地区：[1]大连大学附属新华医院神经内三科,116021

出　　处：《中国医师进修杂志》2017年第12期1095-1099,共5页Chinese Journal of Postgraduates of Medicine

基　　金：大连市卫生局课题（2015-109）

摘　　要：目的 通过与定量感觉检查（QST）和神经传导检查（NCS）的对比分析,评价F波检测在糖尿病周围神经病变（DPN）电生理检查诊断中的应用价值.方法 回顾性分析有DPN症状的糖尿病患者314例,按糖尿病病程分为≤3年组、4~6年组、7~9年组、〉9年组.检测QST、NCS、F波,统计分析各组检测异常率.结果 在病程早期（≤3年组、4~6年组）,QST异常率[76.54%（62/81）、91.67%（88/96）]〉F波异常率[（48.15%（39/81）、64.58%（62/96）]〉NCS异常率[（32.10%（26/81）、47.92%（46/96）],差异均有统计学意义（P〈0.01）;病程超过6年（7~9年组、〉9年组）,三种方法异常率比较均差异无统计学意义（P〉0.05）.QST异常率：4~6年组异常率[（91.67%（88/96）]高于≤3年组[（76.54%（62/81）],7~9年组及〉9年组QST异常率反而略有下降;NCS异常率：NCS异常率随病程增加而增加,相邻病程之间增幅明显;F波异常率：F波异常率随病程增加而增加,在4~6年组增幅明显,之后增幅减缓.在≤3年组和4~6年组,增加单纯F波异常的患者人数,可将NCS＋F波异常率分别由30.86%（25/81）、44.79%（43/96）提升至46.91% （38/81）、61.46%（59/96）,7~9年组及〉9年组NCS＋F波异常率分别由69.44%（50/72）、84.61% （55/65）提升至72.22%（52/72）、86.15%（56/65）.结论 早期（病程≤6年）糖尿病患者F波检出率虽不及QST,但仍具备有较高水平;F波检出率与病程正相关性较好,反映病情相对客观可靠;早期评估DPN,增加F波检测可在NCS基础上进一步提高检出率.Objective To evaluate the application value of F wave by comparison with quantitative sensory testing（QST）and nerve conduction studies（NCS）in diabetes peripheral neuropathy （DPN）. Methods Three hundred and fourteen diabetic patients with symptom of DPN were retrospectively analyzed, who were recruited and divided into four groups according the course of diabetes mellitus： ≤ 3 years group, 4-6 years group, 7-9 years group and 〉9 years group. The abnormal rates of QST, NCS and F wave were analyzed and compared. Results At earlier course of disease （≤ 3 years group, 4- 6 years group）, the abnormal rate of QST [76.54%（62/81）, 91.67% （88/96）]〉F wave[（48.15%（39/81）,64.58%（62/96）]〉NCS[（32.10%（26/81）,47.92%（46/96）], and there were significant differences（P〈0.01）.The abnormal rate of QST, F wave and NCS at 7-9 years group and〉9 years group had no significant differences（P〉0.05）.The abnormal rate of QST in 4-6 years group[（91.67%（88/96）]was higher than that in≤3 years group[（76.54%（62/81）],and decreased in 7-9 years group and 〉9 years group. The abnormal rate of NCS was increased with course of disease, and the range was obviously between close together group. The abnormal rate of F wave was increased with course of disease,but in 4-6 years group the range was obvious and the range was slow down.At earlier course of disease （≤3 years group, 4-6 years group）, the abnormal rate of only F wave significantly increased the abnormal rate of NCS ＋ F wave from 30.86%（25/81）, 44.79% （43/96）to 46.91%（38/81）, 61.46%（59/96）respectively, but in 7-9 years group and〉9 years group, the abnormal rate of only F wave increased the abnormal rate of NCS ＋ F wave from 69.44%（50/72）, 84.61%（55/65）to 72.22% （52/72）,86.15%（56/65）.Conclusions Although the abnormal rate of F wave is not as high as QST, it is still remarkable. Detection of F wave shows positive correlations with the course of disease, which can reflect the

关 键 词：糖尿病神经病变 F波 定量感觉检查 神经传导检查 对比研究 

分 类 号：R587.2[医药卫生—内分泌]