糖尿病周围神经病变合并腕管综合征的电生理特点分析  

Analysis of electrophysiological characteristics in patients with diabetic peripheral neuropathy combined with carpal tunnel syndrome

作　　者：姜明[1] 胡洪涛[1] 闫欣[1] 闫立荣[1] 詹研博 JIANG Ming;HU Hongtao;YAN Xin(Department of Nerurology,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院神经内科,100035

出　　处：《中国糖尿病杂志》2018年第7期566-568,共3页Chinese Journal of Diabetes

摘　　要：目的 分析糖尿病周围神经病变(DPN)合并腕管综合征(CTS)的电生理特点,探讨电生理检查对于鉴别DPN合并CTS的诊断价值。方法 将2013年5月至2017年4月于我院门诊和病房收治的DPN、CTS及DPN合并CTS患者共122例进行回顾性分析,分为CTS组51例、DPN组30例、DPN合并CTS组(DPN+CTS)41例,另选健康对照(NC)组32名,行神经电生理检查包括正中神经运动末端潜伏期(DML)、正中神经复合肌肉动作电位(CMAP)、正中神经感觉传导速度(SCV)、正中神经分段SCV(指-掌SCV及掌-腕SCV)、正中-桡神经潜伏期差(MRLD)及正中-尺神经潜伏期差(MULD)。结果 DPN+CTS组掌-腕SCV低于DPN组[(37.66±5.78)vs(45.57±3.89)m/s,P<0.05],MRLD、MULD大于DPN组[(0.56±0.19)vs(0.19±0.08)ms,(0.57±0.18)vs(0.20±0.09)ms,P<0.05];DPN组、DPN+CTS组与NC组比较,正中神经DML均延长[(3.99±0.57)vs(4.68±0.88)vs(3.24±0.37)ms,P<0.05],SCV均降低[(46.22±5.46)vs(41.39±5.25)vs(52.60±3.36)m/s,P<0.05]。结论 常规电生理检查鉴别DPN合并CTS有一定困难,分段感觉传导速度SCV及MRLD、MULD对鉴别DPN合并CTS有诊断价值。Objective To analyze the electrophysiological characteristics of diabetic peripheral neuropathy（DPN） with carpal tunnel syndrome（CTS）and to determine the diagnostic value of electrophysiological examination for DPN with CTS. Methods 51 patients with CTS,30 with DPN and41 patients combined DPN with CTS admitted to our hospital from May 2013 to April 2017 were included in this retrospective analysis.32 healthy volunteers served as normal control group.Electrophysiological examination including DML,CMAP,SCV,segmental SCV,MRLD and MRLD were performed and compared. Results Compared with DPN group,patients in DPN＋ CTS group had lower SCV of palmar wrist[（37.66±5.78）vs（45.57±3.89）m/s,P〈0.05]and higher MRLD（0.56±0.19）vs（0.19±0.08）ms and MULD（0.57±0.18）vs（0.20±0.09）ms（P〈0.05）.Compared with NC group,the median nerve DML in DPN group and DPN＋CTS group was significantly longer[（4.68±0.88）vs（3.99±0.57）vs（3.24±0.37）ms,P〈0.05].SCV in DPN group and DPN＋CTS group was significantly slower than that in NC group[（41.39±5.25）vs（46.22±5.46）vs（52.60±3.36）m/s,P〈0.05].Conclusion Segmented SCV,MRLD and MULD have certain diagnostic value for DPN with CTS.

关 键 词：糖尿病周围神经病变 腕管综合征 分段SCV 正中-桡神经潜伏期差 正中-尺神经潜伏期差 

分 类 号：R587.2[医药卫生—内分泌]