中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2015年
3期
188-191
,共4页
田丽%程焱%张哲成%刘娜%朱炬
田麗%程焱%張哲成%劉娜%硃炬
전려%정염%장철성%류나%주거
糖尿病神经病变%运动神经元%神经纤维%神经传导
糖尿病神經病變%運動神經元%神經纖維%神經傳導
당뇨병신경병변%운동신경원%신경섬유%신경전도
Diabetic neuropathies%Motor neurons%Nerve fibers%Neural conduction
目的 利用单纤维传导检测技术评价糖尿病周围神经病(DPN)患者的运动神经纤维功能状态.方法 参照2009年多伦多会议DPN的诊断标准,依据腓总神经常规神经传导检测结果,选取2012年10月至2013年10月于天津市第三中心医院内分泌科、神经内科就诊的65例DPN患者作为研究对象;其中感觉异常组(S-DPN组)33例,感觉运动异常组(SM-DPN组)32例,并以天津市第三中心医院体检中心同期体检的34名健康志愿者作对照.全部受试者接受腓总神经单纤维传导速度(SF-CV)及其末端运动潜伏期(SF-DML)的检测,并对其与DPN患者糖尿病病程、空腹血糖、糖化血红蛋白(HbA1 c)水平的相关性进行分析.结果 S-DPN组的SF-CV[(43.1±3.6) m/s]明显低于对照组[(47.5±3.3) m/s,t=5.077,P＜0.01],SF-DML[(3.6±0.7)ms]与对照组[(3.4±0.5)ms]相比,差异无统计学意义;运动神经传导速度[MCV,(49.5 ±2.6)m/s]及末端运动潜伏期[DML,(3.4±0.6)ms]与对照组[(50.9±3.5) m/s、(3.2±0.5)ms]相比差异无统计学意义.SM-DPN组的SF-CV[(35.2 ±3.6) m/s,t =9.119、14.219]及MCV[(40.9±3.2)m/s,t=11.131、13.025]较S-DPN组及对照组减慢(P＜0.01),SF-DML[(4.5 ±0.7)ms,t=5.692、7.231]、DML[(4.2±0.7) ms,t=5.561、6.975]较S-DPN组及对照组延长(P＜0.01).DPN患者的SF-CV与糖尿病病程呈负相关(r=-0.340,P=0.006),与空腹血糖、HbA1c水平无相关性;SF-DML与糖尿病病程、空腹血糖、HbA1c水平元相关性.结论 SF-CV检测较MCV检测更易早期发现DPN患者的运动神经纤维损害,其SF-CV随着糖尿病病程的延长而减慢.
目的 利用單纖維傳導檢測技術評價糖尿病週圍神經病(DPN)患者的運動神經纖維功能狀態.方法 參照2009年多倫多會議DPN的診斷標準,依據腓總神經常規神經傳導檢測結果,選取2012年10月至2013年10月于天津市第三中心醫院內分泌科、神經內科就診的65例DPN患者作為研究對象;其中感覺異常組(S-DPN組)33例,感覺運動異常組(SM-DPN組)32例,併以天津市第三中心醫院體檢中心同期體檢的34名健康誌願者作對照.全部受試者接受腓總神經單纖維傳導速度(SF-CV)及其末耑運動潛伏期(SF-DML)的檢測,併對其與DPN患者糖尿病病程、空腹血糖、糖化血紅蛋白(HbA1 c)水平的相關性進行分析.結果 S-DPN組的SF-CV[(43.1±3.6) m/s]明顯低于對照組[(47.5±3.3) m/s,t=5.077,P＜0.01],SF-DML[(3.6±0.7)ms]與對照組[(3.4±0.5)ms]相比,差異無統計學意義;運動神經傳導速度[MCV,(49.5 ±2.6)m/s]及末耑運動潛伏期[DML,(3.4±0.6)ms]與對照組[(50.9±3.5) m/s、(3.2±0.5)ms]相比差異無統計學意義.SM-DPN組的SF-CV[(35.2 ±3.6) m/s,t =9.119、14.219]及MCV[(40.9±3.2)m/s,t=11.131、13.025]較S-DPN組及對照組減慢(P＜0.01),SF-DML[(4.5 ±0.7)ms,t=5.692、7.231]、DML[(4.2±0.7) ms,t=5.561、6.975]較S-DPN組及對照組延長(P＜0.01).DPN患者的SF-CV與糖尿病病程呈負相關(r=-0.340,P=0.006),與空腹血糖、HbA1c水平無相關性;SF-DML與糖尿病病程、空腹血糖、HbA1c水平元相關性.結論 SF-CV檢測較MCV檢測更易早期髮現DPN患者的運動神經纖維損害,其SF-CV隨著糖尿病病程的延長而減慢.
목적 이용단섬유전도검측기술평개당뇨병주위신경병(DPN)환자적운동신경섬유공능상태.방법 삼조2009년다륜다회의DPN적진단표준,의거비총신경상규신경전도검측결과,선취2012년10월지2013년10월우천진시제삼중심의원내분비과、신경내과취진적65례DPN환자작위연구대상;기중감각이상조(S-DPN조)33례,감각운동이상조(SM-DPN조)32례,병이천진시제삼중심의원체검중심동기체검적34명건강지원자작대조.전부수시자접수비총신경단섬유전도속도(SF-CV)급기말단운동잠복기(SF-DML)적검측,병대기여DPN환자당뇨병병정、공복혈당、당화혈홍단백(HbA1 c)수평적상관성진행분석.결과 S-DPN조적SF-CV[(43.1±3.6) m/s]명현저우대조조[(47.5±3.3) m/s,t=5.077,P＜0.01],SF-DML[(3.6±0.7)ms]여대조조[(3.4±0.5)ms]상비,차이무통계학의의;운동신경전도속도[MCV,(49.5 ±2.6)m/s]급말단운동잠복기[DML,(3.4±0.6)ms]여대조조[(50.9±3.5) m/s、(3.2±0.5)ms]상비차이무통계학의의.SM-DPN조적SF-CV[(35.2 ±3.6) m/s,t =9.119、14.219]급MCV[(40.9±3.2)m/s,t=11.131、13.025]교S-DPN조급대조조감만(P＜0.01),SF-DML[(4.5 ±0.7)ms,t=5.692、7.231]、DML[(4.2±0.7) ms,t=5.561、6.975]교S-DPN조급대조조연장(P＜0.01).DPN환자적SF-CV여당뇨병병정정부상관(r=-0.340,P=0.006),여공복혈당、HbA1c수평무상관성;SF-DML여당뇨병병정、공복혈당、HbA1c수평원상관성.결론 SF-CV검측교MCV검측경역조기발현DPN환자적운동신경섬유손해,기SF-CV수착당뇨병병정적연장이감만.
Objective To assess the function of motor nerve fiber in patients with diabetic peripheral neuropathy (DPN) by single-fiber conduction studies.Methods According to the diagnostic standard of DPN issued in Toronto meeting in 2009,on the basis of the result of peroneal nerve conventional conduction study,a total of 65 patients with DPN in the Department of Endocrinology and the Department of Neurology of Tianjin Third Central Hospital from October 2012 to October 2013 were enrolled into the study,from whom 33 had abnormal sensory conduction (sensory-diabetic peripheral neuropathy group,S-DPN group),32 had abnormal sensory motor conduction (sensory motor-diabetic peripheral neuropathy group,SM-DPN group).Single-fiber conduction velocity (SF-CV) and single-fiber distal motor latency (SF-DML)were detected in all subjects.The obtained results were compared with the data from 34 healthy volunteers (control group).The relationship of SF-CV,SF-DML and the duration of diabetes mellitus,fasting glucose,HbA1 c was also studied in DPN patients.Results The SF-CV ((43.1 ± 3.6) m/s) was decreased in S-DPN group compared with control group ((47.5 ± 3.3) m/s,t =5.077,P ＜ 0.01).There were no significant differences in SF-DML ((3.6 ± 0.7) ms),motor nerve conduction velocity (MCV (49.5 ± 2.6)m/s) and DML ((3.4 ± 0.6) ms) in S-DPN group compared with that of control group ((3.4 ± 0.5) ms,(50.9 ± 3.5) m/s,(3.2 ± 0.5) ms,respectively).SM-DPN group had lower SF-CV ((35.2 ± 3.6)m/s,t =9.119,14.219),MCV ((40.9 ± 3.2) m/s,t =11.131,13.025) and increased SF-DML ((4.5±0.7) ms,t=5.692,7.231),DML ((4.2 ±0.7) ms,t=5.561,6.975) compared with the other two groups (P ＜0.01).SF-CV in DPN patients was negatively related to the diabetic duration (r =-0.340,P =0.006),while SF-DML had no correlation with duration of DM,fasting blood glucose and HbAlc.Conclusions Detection of SF-CV is easy to find early motor nerve dysfunction in DPN patients.SF-CV is decreased with the increasing duration of diabetes.
