糖尿病患者74例外周神经病变筛查结果分析  

Analysis of screening results of peripheral neuropathy in 74 patients with diabetes mellitu

作　　者：谢文超 Xie Wenchao(The Health Center of Linhu Town,Wuzhong District,Jiangsu Suzhou 215106)

机构地区：[1]吴中区临湖镇卫生院,江苏苏州215106

出　　处：《中国社区医师》2020年第35期63-64,共2页Chinese Community Doctors

摘　　要：目的:探讨基层医院开展糖尿病外周神经病变(DPN)筛查工作的有效方法及可行性。方法:选取2017年5-6月糖尿病患者74例,进行神经症状评分,结合5项(10 g单纤维尼龙丝触觉、温度觉、痛觉、128 Hz震动觉、踝反射)神经感觉检查结果,综合评价筛查的阳性率及单项检查方法的敏感性及特异性。结果:筛查结果阳性25例(33.78%)。25例阳性患者中,痛觉、温度觉、10 g单纤维尼龙丝触觉、128 Hz震动觉、踝反射这5项检查的灵敏度分别为48%、68%、40%、40%、64%;特异度分别为75.51%、87.76%、81.63%、91.84%、85.71%。温度觉联合踝反射检查灵敏度为84%;温度觉、踝反射、128 Hz振动觉3种检查方法联合灵敏度为88%。结论:基层医院在医疗设备条件不足的情况下,首选踝反射+温度觉+128 Hz震动觉检查组合进行糖尿病外周神经病变筛查;对初步筛查阳性的患者,以神经症状评分+神经障碍评分诊断标准进行临床诊断后,可以直接开展相关治疗干预措施,进一步达到防治结合的目的。Objective:To explore the effective method and feasibility of(DPN)screening for diabetic peripheral neuropathy in grass-roots hospitals.Methods:From May to June 2017,74 patients with diabetes mellitus were selected for neurological symptom score,combined with the results of 5 neurosensory tests(10 g monofilament nylon tactile,temperature sensation,pain sensation,128 Hz vibration sensation,ankle reflex)to comprehensively evaluate the positive rate of screening and the sensitivity and specificity of individual examination.Results:The screening results were positive in 25 cases(33.78%).Among the 25 positive patients,the sensitivities of pain,temperature sensation,10 g monofilament nylon tactile sensation,128 Hz vibration sensation and ankle reflex were 48%,68%,40%,40%and 64%,respectively,and the specificity were 75.51%,87.76%,81.63%,91.84%and 85.71%,respectively.The sensitivity of temperature sensation combined with ankle reflex test was 84%,and the combined sensitivity of temperature sensation,ankle reflex and 128 Hz vibration sensation was 88%.Conclusion:Under the condition of insufficient medical equipment,primary hospitals choose the combination of ankle reflex,temperature sensation and 128 Hz vibration sensation to screen diabetic peripheral neuropathy,and for patients with positive initial screening,after clinical diagnosis with neurological symptom score+neurological disorder score diagnostic criteria,we can directly carry out relevant treatment and intervention measures to further achieve the purpose of combination of prevention and treatment.

关 键 词：糖尿病外周神经病变 筛查 灵敏度 特异度 

分 类 号：R587.2[医药卫生—内分泌]