2型糖尿病患者周围神经肌电图改变与临床指标及病程相关性分析  

Correlation analysis of peripheral nerves electromyography changes with clinical indicators and disease course in patients with type 2 diabetes mellitus

作　　者：刘德珍[1] 周玮 LIU Dezhen;ZHOU Wei(Department of Endocrine,the Affiliated Huai′an No.1 People′s Hospital of Nanjing Medical University,Huai′an,JiangSu 223001,China;Department of Endocrine,Huai′an RuiJi Hospital,Huai′an,JiangSu 223001,China)

机构地区：[1]南京医科大学附属淮安第一医院内分泌科,江苏淮安223001 [2]淮安瑞济医院内分泌科,江苏淮安223001

出　　处：《现代医药卫生》2022年第6期938-942,947,共6页Journal of Modern Medicine & Health

基　　金：南京医科大学科技发展基金(NMUB2020136)。

摘　　要：目的探讨2型糖尿病(T2DM)患者的周围神经肌电图(EMG)改变与临床指标[糖化血红蛋白(HbA1C)、高密度脂蛋白(HDL)、尿游离皮质醇]及病程的相关性。方法回顾性分析2020年12月至2021年6月南京医科大学附属淮安第一医院收治的127例T2DM患者的神经EMG具体结果(下肢感觉和运动神经及自主神经测定)与临床指标(HbA1C、HDL、尿游离皮质醇)、病程之间的相关性。结果尿游离皮质醇与胫神经运动(踝-AH)波幅呈正相关[左侧相关系数(r)=0.209,P=0.019;右侧r=0.189,P=0.034]。HDL与胫神经运动(腘窝-踝)潜伏期(Lat)呈负相关(左侧r=-0.213,P=0.016;右侧r=-0.210,P=0.018)。HbA1C与胫神经运动(踝-AH)Lat呈正相关(左侧r=0.187,P=0.036;右侧r=0.187,P=0.035)。糖尿病病程与运动感觉神经损害有明显的相关性,且这种相关性与周围神经损害的类型广泛相关。结论T2DM病程、HbA1C、HDL、尿皮质醇和糖尿病周围神经EMG改变有关,尿游离皮质醇主要和神经轴索损害有关,HDL和HbA1C主要与神经髓鞘损害有关,病程主要与运动感觉神经损害有关。Objective To investigate the correlation between peripheral nerves electromyography(EMG)changes and clinical indicators[glycosylated hemoglobin(HbA1C),high-density lipoprotein(HDL),urinary free cortisol]and disease course in patients with type 2 diabetes mellitus(T2DM).Methods The correlation between the specific results of neuro EMG(sensory and motor nerves of lower limbs and autonomic nerves),clinical indicators[glycated hemoglobin(HbA1C),HDL,urinary free cortisol]and disease course of 127 T2DM patients admitted to Huai′an First Hospital Affiliated to Nanjing Medical University from December 2020 to June 2021 was retrospectively analyzed.Results Urinary free cortisol was positively correlated with tibial nerve movement(ankle-AH)[left correlation coefficient(r)=0.209,P=0.019;right r=0.189,P=0.034].HDL was negatively correlated with tibial nerve movement(popliteal fossa-ankle)latency(Lat)(left r=-0.213,P=0.016;right r=-0.210,P=0.018).HbA1C was positively correlated with tibial nerve motor(ankle-AH)Lat(left r=0.187,P=0.036;right r=0.187,P=0.035).There was a significant correlation between the disease course of diabetes mellitus and motor-sensory nerve damage,and this correlation was widely correlated with the types of peripheral nerve damage.Conclusion The disease course of T2DM,HbA1C,HDL and urinary cortisol are related to the changes of EMG in T2DM.Urinary-free cortisol is mainly related to nerve axonal damage,while HDL and HbA1C are mainly related to the nerve myelin sheath damage,disease course is mainly related to motor-sensory nerve damage.

关 键 词：2型糖尿病 肌电图 尿游离皮质醇 高密度脂蛋白 糖化血红蛋白 

分 类 号：R587.2[医药卫生—内分泌]