高频超声联合神经调节素1、正常T细胞表达和分泌因子检测对2型糖尿病周围神经病变的诊断价值  

Diagnostic Value of High-Frequency Ultrasound Combined with Neuregulin 1 and Regulated on Activation in Normal T-Cell Expressed and Secreted in Type 2 Diabetes Mellitus Peripheral Neuropathy

作　　者：董鹏 于冬 张书晨 纪海霞 杨超 Dong Peng;Yu Dong;Zhang Shuchen(Department of Ultrasound Diagnosis,Yantai Yeda Hospital,Yantai,Shandong 264000;Department of Ultrasound,Fengfeng General Hospital,North China Medical and Health Group,Handan,Hebei 056000;Department of Ultrasound,Yancheng First People's Hospital,Yancheng,Jiangshu 224000,China)

机构地区：[1]烟台业达医院超声诊断科,山东烟台264000 [2]华北医疗健康集团峰峰总医院超声科,河北邯郸056000 [3]盐城市第一人民医院超声科,江苏盐城224000

出　　处：《四川医学》2025年第3期296-301,共6页Sichuan Medical Journal

基　　金：2019年度邯郸市科技研发计划(编号:19422083051ZC)。

摘　　要：目的探究高频超声联合神经调节素1(NRG1)、正常T细胞表达和分泌因子(RANTES)检测对2型糖尿病(T2DM)周围神经病变(DPN)的诊断价值。方法选取2021年9月至2023年9月我院收治的181例T2DM患者,按照其是否发生DPN分为单纯T2DM组85例和DPN组96例。肌电图检查检测运动神经传导速度(正中神经、尺神经、胫神经)和感觉神经传导速度(正中神经、尺神经、腓肠神经)。用高频线阵探头进行测量横截面积(CSA),观察血流、内部结构、内部回声状况。本次高频超声检测为DPN的有75例。采用ELISA法检测血清NRG1、RANTES水平。绘制ROC曲线分析高频超声联合血清NRG1、RANTES检测对T2DM合并DPN的诊断价值。结果与单纯T2DM组相比,DPN组运动神经传导速度(正中神经、尺神经、胫神经)和感觉神经传导速度(正中神经、尺神经、腓肠神经)均显著降低(P<0.05)。与单纯T2DM组相比,DPN组CSA、血流、内部结构消失、内部回声减低的比例均显著升高(P<0.05)。DPN组血清中NRG1和RANTES水平均显著高于单纯T2DM组(P<0.05)。与单独诊断相比,高频超声联合血清NRG1、RANTES检测对T2DM合并DPN诊断的AUC显著升高(Z_(高频超声-高频超声+NRG1+RANTES)=5.378,P<0.001;Z_(NRG1-高频超声+NRG1+RANTES)=5.518,P<0.001;Z _(RANTES-高频超声+NRG1+RANTES)=4.393,P<0.001)。结论T2DM合并DPN患者血清中NRG1和RANTES呈高表达,高频超声联合血清NRG1、RANTES检测能够提高对T2DM合并DPN的诊断效能。Objective To investigate the diagnostic value of high-frequency ultrasound combined with neuregulin 1(NRG1)and regulated on activation in normal T-cell expressed and secreted(RANTES)in type 2 diabetes mellitus(T2DM)peripheral neuropathy(DPN).Methods From September 2021 to September 2023,total 181 patients with T2DM were enrolled and grouped into 85 cases in T2DM group and 96 cases in DPN group according to whether they developed DPN or not.Electromyography(EMG)was used to detect motor nerve conduction velocity(median nerve,ulnar nerve,tibial nerve)and sensory nerve conduction velocity(median nerve,ulnar nerve,sural nerve).The cross-sectional area(CSA)was measured with a high-frequency linear array probe to observe blood flow,internal structure,and internal echo conditions.There were 75 cases of DPN detected by high-frequency ultrasonography.ELISA was used to detect serum NRG1 and RANTES.The diagnostic value of high-frequency ultrasound combined with serum NRG1 and RANTES detection in the diagnosis of T2DM complicated with DPN was analyzed by ROC curves.Results Compared with T2DM group,the motor nerve conduction velocity(median nerve,ulnar nerve,tibial nerve)and sensory nerve conduction velocity(median nerve,ulnar nerve,and sural nerve)were obviously decreased in DPN group(P<0.05).Compared with T2DM group,the CSA,blood flow,proportions of internal structure loss and internal echo reduction were obviously higher in DPN group(P<0.05).The serum NRG1 and RANTES in DPN group were obviously higher than those in T2DM group(P<0.05).Compared with the diagnosis alone,the AUC of high-frequency ultrasound combined with serum NRG1 and RANTES in the diagnosis of T2DM and DPN was obviously higher(Z _(high-frequency ultrasound-high-frequency ultrasound+NRG1+RANTES)=5.378,P<0.001;Z _(NRG1-high-frequency ultrasound+NRG1+RANTES)=5.518,P<0.001;Z _(RANTES-high-frequency ultrasound+NRG1+RANTES)=4.393,P<0.001).Conclusion NRG1 and RANTES are highly expressed in the serum of patients with T2DM combined with DPN.High-frequency ultrasound c

关 键 词：高频超声 神经调节素1 正常T细胞表达和分泌因子 2型糖尿病 周围神经病变 诊断 

分 类 号：R587.1[医药卫生—内分泌]