高频超声评价2型糖尿病患者坐骨神经病变的诊断价值  

Diagnostic value of high⁃frequency ultrasonography for sciatic nerve changes in patients with type 2 diabetes mellitus

作　　者：孙友胜 经朝龙 陈杰 张建勇 盛剑 张辉 SUN Yousheng;JING Chaolong;CHEN Jie(Department of Ultrasound,Yangzhou Hospital of TCM,Yangzhou 225001,China)

机构地区：[1]扬州市中医院超声医学科,225001 [2]扬州市中医院内分泌科,225001

出　　处：《中国糖尿病杂志》2023年第3期196-200,共5页Chinese Journal of Diabetes

基　　金：扬州市中医院院级科技项目(2022YNKT06B)。

摘　　要：目的 探讨高频超声评价T2DM患者坐骨神经病变的诊断价值。方法 选取2016年11月至2020年11月于我院内分泌科就诊的T2DM患者140例,分为单纯T2DM组(T2DM,n=62)及T2DM合并糖尿病周围神经病变(DPN)组(DPN,n=78),另选取同期体检健康者80名为正常对照(NC)组。应用高频超声评价坐骨神经形态学改变。结果 DPN组各位点宽径(W)、厚径(T)、横截面积(CSA)较NC组均增大(P<0.05),与T2DM组比较,除股骨中段处W、分叉处上方1 cm处T及臀线处T/W外,其余位点均增大(P<0.05);T2DM组仅在臀线处W、分叉处上方1 cm处T/W及各位点CSA较NC组增大(P<0.05);坐骨神经分叉处上方1 cm处CSA诊断DPN最敏感,诊断效能最高。结论 高频超声为临床诊断T2DM患者坐骨神经并发症提供影像依据,值得推广和应用。Objective To explore the diagnostic value of high-frequency ultrasonography for sciatic nerve changes in patients with type 2 diabetic mellitus(T2DM).Methods 140 patients with T2DM were selected from November 2016 to November 2020 and were divided into 62 cases with simple diabetes(T2DM group)and 78 cases with DPN(DPN group).80 healthy volunteers were set as normal control group(NC group).High frequency ultrasound was used to evaluate the morphological changes of sciatic nerve.Results Compared with NC group,DPN group had higher W,T and CSA values at each site(P<0.05).Compared with T2DM group,except the W value at the middle femur,the T value at 1 cm above the bifurcation,and the T/W ratio at the gluteal line,the measured values at other sites were all higher in DPN group(P<0.05).Compared with NC group,only W at the gluteal line,T/W at 1 cm above the bifurcation,and CSA at each point were elevated in T2DM group(P<0.05).The value of CSA at 1 cm above the bifurcation of sciatic nerve was the most sensitive index with the highest diagnostic efficiency for DPN.Conclusion High-frequency ultrasonography can provide imaging evidence for the diagnosis of sciatic nerve complications in T2DM patients,which is worthy of clinical promotion and application.

关 键 词：超声 糖尿病周围神经病变 坐骨神经 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.2[医药卫生—诊断学] R745[医药卫生—临床医学]