探讨F波联合SSR和NCV在糖尿病周围神经病早期的诊断价值  

The value of F-Wave combined with SSR and NCV in the early diagnosis of diabetic peripheral neuropathy

作　　者：马彦[1] 樊继军[1] 段玉琼[1] 吴鹏 尹晓梅 MA Yan;FAN Jijun;DUAN Yuqiong;WU Peng;YIN Xiaomei(The First People’s Hospital of Shizuishan,Shizuishan 753200,China)

机构地区：[1]宁夏石嘴山市第一人民医院,宁夏石嘴山753200

出　　处：《宁夏医学杂志》2023年第9期808-811,共4页Ningxia Medical Journal

基　　金：宁夏回族自治区卫生健康委员会重点科研课题(2018NW075);石嘴山市科技攻关计划项目(201820)。

摘　　要：目的探讨F波联合皮肤交感反应(SSR)和常规神经传导检测(NCV)对糖尿病周围神经病(DPN)早期的诊断价值。方法对324例2型糖尿病患者,根据有无周围神经症状分为无症状组(103例)、有症状组(221例)及同期对照组(100例),均行正中神经和胫神经F波,四肢感觉、运动神经传导检测(NCV)和SSR检查。分析比较组间F波、NCV和SSR指标的临床特点。结果糖尿病患者下肢运动、感觉神经损害程度重于上肢,且四肢感觉神经异常比例高于运动神经(P<0.05);对糖尿病有症状组、无症状组进行SSR和NCV联合检测,总异常率为90.1%,明显高于单独应用NCV异常率,差异有统计学意义(P<0.05)。与对照组比较,糖尿病(DM)有症状组上肢正中神经F波出现率减少,F波传导速度减慢,下肢胫神经F波出现率减少,F波潜伏期延长。无症状组仅上肢正中神经F波出现率减少。与DM无症状组比较,有症状组上肢正中神经F波传导速度减慢,下肢F波出现率减少,F波潜伏期延长(P<0.05),而上肢F波出现率差异无统计学意义(P>0.05)。对糖尿病组进行NCV、SSR和F波联合检测异常率为93.2%,明显高于单纯NCV检测(P<0.05)。结论糖尿病在早期无症状时即存在周围神经损害,以小纤维受累为主,F波、SSR联合NCV检测能有效弥补NCV不能反映自主神经小纤维和运动神经近端功能的不足,提高对DPN的早期诊断。Objective To explore the value of combining the F-wave and the Skin Sympathetic Response(SSR)and Nerve Conduction Velocity(NCV)test in the early diagnosis of diabetic peripheral neuropathy(DPN).Methods F waves of median and tibial nerves,sensory and motor nerve conduction tests(NCV)of the extremities and SSR were performed in 324 patients with type 2 diabetic mellitus,which were divided into an asymptomatic group(n=103)and a symptomatic group(n=221)according to the presence or absence of peripheral nerve symptoms,and in the same period,100 patients in normal control group(n=100)were observed.The clinical characteristics of the F wave,NCV and SSR were analyzed between three groups.Results Compared with diabetic patients,the damage of motor and sensory nerves of the lower limbs was heavier than that of the upper limbs,and the proportion of abnormalities of sensory nerves of the four limbs was higher than that of motor nerves(P<0.05);The whole abnormal rate of the combined detection of SSR and NCV for the diabetic symptomatic and asymptomatic groups was 90.1%,and the total abnormal rate of SSR was 84.2% and that of NCV was 74.3% in the diabetic group used alone,which was significantly higher than that of the abnormality rate of the application of NCV alone,with a statistically significant difference(P<0.05).Compared with the control group,the DM symptomatic group had a reduced rate of F-wave appearance in the median nerve of the upper limb and a slowed F-wave conduction velocity,and a reduced rate of F-wave appearance in the tibial nerve of the lower limb and a prolonged F-wave latency.In the asymptomatic group,only the rate of F-wave appearance in the median nerve of the upper limb was reduced.Compared with the DM asymptomatic group,the symptomatic group had a slower F-wave conduction velocity in the median nerve of the upper extremity,a reduced rate of F-wave appearance in the lower extremity,and a prolonged F-wave latency(P<0.05),while the difference in the rate of F-wave appearance in the upper extremity was not

关 键 词：糖尿病周围神经病变 肌电图 F波 神经传导速度检测 交感神经反应 

分 类 号：R741.044[医药卫生—神经病学与精神病学]