CAJ | 학술논문

目的：观察密歇根神经筛查量表（MNSI）在糖尿病远端对称性多神经病变（DSPN）中的诊断截点。方法对293例T2DM患者施行MNSI及神经电生理检查、神经病变症状、体征检查，根据DSPN诊断标准分为合并DSPN者（DM＋DSPN组）196例和单纯糖尿病者（DM组）97例。采用Logistic回归分析对MNSI量表各项指标进行双重权重后做出受试者工作特征曲线（ROC），比较曲线下面积（AUC）。结果以问卷7分作为截点，漏诊率为61.43％；以体格检查评分2分作为截点，漏诊率为1.37％；问题1、3、9、11和踝反射、振动觉检查与全项筛查的效果比较，差异无统计学意义（P＝0.088）。结论可将MNSI问卷评分诊断截点定为4分，体格检查评分截点定为2分。
목적：관찰밀헐근신경사사량표（MNSI）재당뇨병원단대칭성다신경병변（DSPN）중적진단절점。방법대293례T2DM환자시행MNSI급신경전생리검사、신경병변증상、체정검사，근거DSPN진단표준분위합병DSPN자（DM＋DSPN조）196례화단순당뇨병자（DM조）97례。채용Logistic회귀분석대MNSI량표각항지표진행쌍중권중후주출수시자공작특정곡선（ROC），비교곡선하면적（AUC）。결과이문권7분작위절점，루진솔위61.43％；이체격검사평분2분작위절점，루진솔위1.37％；문제1、3、9、11화과반사、진동각검사여전항사사적효과비교，차이무통계학의의（P＝0.088）。결론가장MNSI문권평분진단절점정위4분，체격검사평분절점정위2분。
Objective To investigate the cutoff point of the michigan neuropathy screening instrument(MNSI) in the diagnosis of type 2 diabetic distal symmetric polyneuropathy(DSPN). Methods 293 T2DM patients accepted symptoms and physical neuropathy examinations ,M NSI evaluation and electrophysiological examinations. Based on Toronto DSPN diagnosis standard ,the participants were divided into DSPN group (n=196) and T2DM without DSPN (DM group ,n=97). Weighted regression analysis was used to evaluate the diagnostic performance of each test and search for the possible cutoff points of MNSI by drawing receiver operating characteristic curve (ROC) and comparing the area under the ROC curve. Results When the questionnaire cutoff point was 7 ,the missed diagnosis rate will be 61.43%. When the physical examination cutoff point was 2 ,the missed diagnosis rate will be 1.37%. The value of single question No.1 ,3 ,9 ,11 ,ankle reflex and vibration sensation was similar to the whole index.Conclusion This study recommended that MNSI questionnaire scores 4 and physical examination scores 2 may act as the cutoff points to screen diabetic neuropathy.