西安交通大学学报（医学版）
西安交通大學學報（醫學版）
서안교통대학학보（의학판）
JOURNAL OF XI'AN JIAOTONG UNIVERSITY(MEDICAL SCIENCES)
2015年
4期
568-570,573
,共4页
郭明%王镁%于世家%郝宏铮
郭明%王鎂%于世傢%郝宏錚
곽명%왕미%우세가%학굉쟁
糖尿病%周围神经病变%诊断标准%温度觉%踝反射%振动觉
糖尿病%週圍神經病變%診斷標準%溫度覺%踝反射%振動覺
당뇨병%주위신경병변%진단표준%온도각%과반사%진동각
diabetes%peripheral neuropathy%diagnostic criteria%inspection method%consistency%temperature sense%ankle reflect%vibration sense
目的：评估10 g 尼龙丝、振动觉阈值、温度觉、针刺痛觉、踝反射检查对糖尿病周围神经病变(DPN)的诊断价值,寻找经济、简便、快捷、准确的 DPN 诊断方法。方法分别对151例于辽宁中医药大学附属医院内分泌科住院的糖尿病(DM)患者进行神经传导速度(NCV)测定、10 g 尼龙丝、振动觉阈值、温度觉、针刺痛觉、踝反射检查,以敏感度、特异度、阳性预测值、阴性预测值、约登指数(Youden 指数)和 Kappa 值(k 值)来评估各检查方法的诊断价值。结果5种检查方法中踝反射的敏感度、特异度、阳性预测值、阴性预测值、约登指数及 k 值分别为66.04%、95.56%、97.22%、54.43%、61.60%、0.51,与诊断标准的一致性最好,呈中度一致；压力觉的敏感度、一致性最差；其中温度觉+振动觉+踝反射组合的敏感度、特异度、阳性预测值、阴性预测值、约登指数与 k 值分别为86.79%、91.11%、95.83%、74.55%、77.90%和0.73,与诊断标准呈中高度一致。结论5种检查方法中温度觉+振动觉+踝反射组合与诊断标准呈中高度一致,且经济、简便、易行,临床上可用于对 DPN 的筛查。
目的：評估10 g 尼龍絲、振動覺閾值、溫度覺、針刺痛覺、踝反射檢查對糖尿病週圍神經病變(DPN)的診斷價值,尋找經濟、簡便、快捷、準確的 DPN 診斷方法。方法分彆對151例于遼寧中醫藥大學附屬醫院內分泌科住院的糖尿病(DM)患者進行神經傳導速度(NCV)測定、10 g 尼龍絲、振動覺閾值、溫度覺、針刺痛覺、踝反射檢查,以敏感度、特異度、暘性預測值、陰性預測值、約登指數(Youden 指數)和 Kappa 值(k 值)來評估各檢查方法的診斷價值。結果5種檢查方法中踝反射的敏感度、特異度、暘性預測值、陰性預測值、約登指數及 k 值分彆為66.04%、95.56%、97.22%、54.43%、61.60%、0.51,與診斷標準的一緻性最好,呈中度一緻；壓力覺的敏感度、一緻性最差；其中溫度覺+振動覺+踝反射組閤的敏感度、特異度、暘性預測值、陰性預測值、約登指數與 k 值分彆為86.79%、91.11%、95.83%、74.55%、77.90%和0.73,與診斷標準呈中高度一緻。結論5種檢查方法中溫度覺+振動覺+踝反射組閤與診斷標準呈中高度一緻,且經濟、簡便、易行,臨床上可用于對 DPN 的篩查。
목적：평고10 g 니룡사、진동각역치、온도각、침자통각、과반사검사대당뇨병주위신경병변(DPN)적진단개치,심조경제、간편、쾌첩、준학적 DPN 진단방법。방법분별대151례우료녕중의약대학부속의원내분비과주원적당뇨병(DM)환자진행신경전도속도(NCV)측정、10 g 니룡사、진동각역치、온도각、침자통각、과반사검사,이민감도、특이도、양성예측치、음성예측치、약등지수(Youden 지수)화 Kappa 치(k 치)래평고각검사방법적진단개치。결과5충검사방법중과반사적민감도、특이도、양성예측치、음성예측치、약등지수급 k 치분별위66.04%、95.56%、97.22%、54.43%、61.60%、0.51,여진단표준적일치성최호,정중도일치；압력각적민감도、일치성최차；기중온도각+진동각+과반사조합적민감도、특이도、양성예측치、음성예측치、약등지수여 k 치분별위86.79%、91.11%、95.83%、74.55%、77.90%화0.73,여진단표준정중고도일치。결론5충검사방법중온도각+진동각+과반사조합여진단표준정중고도일치,차경제、간편、역행,림상상가용우대 DPN 적사사。
Objective To evaluate the diagnostic value of the 10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex in the diagnosis of diabetic peripheral neuropathy (DPN)and to search an exact diagnostic method of DPN not only economical but also easy to handle.Methods To carry out the measurements of the NCV,10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex on the patients who have been diagnosed with diabetes (DM)between April 2014 and June 2014 in the endocrinology department of our hospital.The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value serve as assessments of the diagnostic efficiency of clinically diagnostic criteria. Results The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value of the ankle reflex are 66.04%,95.56%,97.22%,54.43%,61.60%,and 0.5 1 in mediate accordance with the diagnostic criteria and it is the best one among the five methods.While the sensitivity and accordance of the pressure sense are of the least accordance with the diagnostic criteria.The correspondent value of the combination of vibration threshold sense,temperature sense and ankle reflex are respectively 86.79%,91.11%,95.83%,74.55%, 77.90% and 0.73,in positive accordance with the diagnostic criteria.Conclusion Among the five methods the consistency between the combination of vibration threshold sense,temperature sense and ankle reflect and diagnostic criteria is of positive accordance and can be applied in screening DPN clinically.
