CAJ | 학술논문

目的应用感觉神经定量检测仪检测糖尿病足患者周围感觉神经,探讨电流感觉阈值(CPT)在糖尿病足发生风险的预测价值.方法测定48例糖尿病足(糖尿病足组)及212例未合并足病的糖尿病患者(非糖尿病足组)的正中神经、腓肠神经于2000hz、250hz、5hz的CPT,并检测患者踝肱指数(ABI)及血糖等代谢指标,记录高血压、冠心病等病史及糖尿病并发症情况.结果与非糖尿病足组患者比较,糖尿病足组患者CPT明显升高,其中5hz(P＜0.01)最为明显；糖尿病足组合并高血压、冠心病、脑梗死、糖尿病肾病、糖尿病视网膜病变的发生率均高于非糖尿病足组(P＜0.01)；糖尿病足组较非糖尿病足组ABI明显降低,在各分度组差异均有统计学意义(P＜0.01).ABI与5hz CPT及250hz CPT均呈负相关(r=-0.454.P＜0.01;r=0.342,P＜0.05).结论糖尿病神经病变的发生与血管病变有关,ABI低、CPT高的患者糖尿病足较单独AB1低的患者糖尿病足发生风险增加,CPT联合ABI较单独检测ABI对于糖尿病足的发生更加有预测价值.
목적 응용감각신경정량검측의검측당뇨병족환자주위감각신경,탐토전류감각역치(CPT)재당뇨병족발생풍험적예측개치.방법 측정48례당뇨병족(당뇨병족조)급212례미합병족병적당뇨병환자(비당뇨병족조)적정중신경、비장신경우2000hz、250hz、5hz적CPT,병검측환자과굉지수(ABI)급혈당등대사지표,기록고혈압、관심병등병사급당뇨병병발증정황.결과 여비당뇨병족조환자비교,당뇨병족조환자CPT명현승고,기중5hz(P＜0.01)최위명현；당뇨병족조합병고혈압、관심병、뇌경사、당뇨병신병、당뇨병시망막병변적발생솔균고우비당뇨병족조(P＜0.01)；당뇨병족조교비당뇨병족조ABI명현강저,재각분도조차이균유통계학의의(P＜0.01).ABI여5hz CPT급250hz CPT균정부상관(r=-0.454.P＜0.01;r=0.342,P＜0.05).결론 당뇨병신경병변적발생여혈관병변유관,ABI저、CPT고적환자당뇨병족교단독AB1저적환자당뇨병족발생풍험증가,CPT연합ABI교단독검측ABI대우당뇨병족적발생경가유예측개치.
Objective To investigate the clinical value of current perception threshold (CPT)examination in screening diabetic peripheral neuropathy in type 2 diabetes mellitus ( DM ) patients with diabetic foot using the neurometer.Methods Forty-eight DM patients with diabetic foot ( diabetic foot group) and 212 DM patients without diabetic foot (pure DM group) were involved in the study.Using the neurometer,CPT testing at 2000,250 and 5 Hz was performed on median and peroneal nerves.Ankle branchial index (ABI) and metabolic index such as plasma glucose were taken on these patients.The history of past illnesses such as hypertension or coronary artery disease and diabetic complications were recorded.Reesults Compared with patients in pure DM group,the CPT in diabetic foot group was significantly higher,especially at low frequency (5 Hz,P ＜ 0.01 ).The prevalence of hypertension,coronary artery disease,brain infarction,diabetic nephropathy was significantly higher,too.The ABI was significantly lower in different degree groups in diabetic foot group than that in pure DM group.There was a significantly negative correlation between the the CPT and the ABI ( 5 Hz:r =- 0.454,P ＜ 0.01.25 Hz:r =- 0.342,P ＜0.05).Coclusions The diabetic patients who had higher CPT and lower ABI were more likely to become paitents with diabetic foot.ABI,combined with CPT examination could detect more patients with diabetic neuropathy and those at risk for diabetic foot than ABI examination alone.