多伦多临床神经病变评分在2型糖尿病周围神经病变筛查中的应用及对临床治疗的评价  

Application of Toronto Clinical Neuropathy Score in Screening of Type 2 Diabetic Peripheral Neuropathy and Its Evaluation on Clinical Treatment

作　　者：杨曼[1] 李奕平[1] 杨莹[1] 毛文文 YANG Man;LI Yi-ping;YANG Ying;MAO Wen-wen(Dept.of Endocrinology,the Fourth Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Dept.of Geriatrics,The Second People’s Hospital of Kunming City,Kunming Yunnan 650204,China)

机构地区：[1]昆明医科大学第四附属医院内分泌科,云南昆明650021 [2]昆明市第二人民医院老年科,云南昆明650204

出　　处：《昆明医科大学学报》2020年第5期75-79,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(31660313);科技创新人才计划基金资助项目(2019HC002)。

摘　　要：目的分析多伦多临床神经病变评分在2型糖尿病周围神经病变筛查中的应用及对临床治疗评价作用。方法选取2018年1月至2019年3月昆明医科大学第四附属医院收治的120例2型糖尿病患者,以多伦多临床神经病变评分量表(toronto clinical scoring system,TCSS)进行糖尿病周围神经病变(diabetic peripheral neuropathies,DPN)筛查,同时行神经肌电图检查,进行对比;随后将TCSS评分在6~19分的患者按照电脑随机法分为观察组和对照组,对照组以维生素B12结合前列地尔进行治疗,观察组则采用硫辛酸结合前列地尔进行治疗。对比TCSS筛查符合率、两组治疗前后TCSS评分变化并分析TCSS对评价DPN治疗的作用和价值。结果120例患者完成TCSS评分时间平均为(11.25±1.48)min,其中≤5分占比41.67%,6~19分占比58.33%;神经肌电图检查阳性率为63.33%;两种方法筛查符合率对比,差异无统计学意义(P>0.05);TCSS评分在6~19分的患者分为观察组和对照组,两组治疗前DPN分级对比,差异无统计学意义(P>0.05),观察组治疗后DPN(-)较治疗前比率明显升高而DPN(+++)较治疗前比率明显降低(P<0.0.5),观察组治疗后DPN(-)比率高于对照组而DPN(+++)低于对照组(P<0.05);两组治疗前TCSS评分对比,差异无统计学意义(P>0.05),两组治疗后TCSS评分相较于治疗前明显降低(P<0.05),观察组治疗后TCSS评分低于对照组(P<0.05)。结论将TCSS评分用于2型糖尿病周围神经病变筛查中效果良好,能够作为筛查DPN的工具;且使用TCSS评分可以对临床治疗方案和效果进行评价,具有良好的推广应用价值。Objective To analyze the application value of Toronto clinical neuropathy score in screening of type 2 diabetic peripheral neuropathy and its evaluation on clinical treatment.Methods A total of 120 patients with type 2 diabetes admitted to our hospital from January 2018 to March 2019 were enrolled in the Toronto Clinical Neurological Scoring System(TCSS)for Diabetic Peripheral Neuropathies(DPN).Screening,Neuromyography as the"gold standard",and patients with TCSS scores of 6 to 19 points were divided into observation group and control group according to computer randomization method.The control group was treated with vitamin B12 combined with alprostadil.The observation group was treated with zinc sulfate combined with alprostadil.The coincidence rate of TCSS screening,the changes of TCSS score before and after treatment,and the effect and value of TCSS on the evaluation of DPN were compared.Results The average time to complete TCSS scores in 120 patients was(11.25±1.48)min,of which≤5 scored 41.67%and 6-19 scored 58.33%.and the positive rate of neurophysiological examination was 63.33%.There was no significant difference in the compliance rate between two groups(P>0.05).Patients with TCSS scores of 6-19 were divided into observation group and control group.There was no significant difference in DPN grade before treatment between the two groups(P>0.05).The ratio of DPN(-)was significantly higher in the observation group and the ratio of DPN(+++)was lower than that before treatment(P<0.0.5).The DPN(-)ratio of the observation group was higher than that of the control group and the DPN(+++)was lower than that of the control group(P<0.05).There was no significant difference in the TCSS scores between the two groups before treatment(P>0.05).The TCSS scores of the two groups were significantly lower than those before treatment(P<0.05).The TCSS scores of the observation group were lower than those of the control group(P<0.05).Conclusions The TCSS score is effective in screening of peripheral neuropathy in type 2 diabe

关 键 词：多伦多临床神经病变评分量表 2型糖尿病 周围神经病变 

分 类 号：R587.2[医药卫生—内分泌]