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目的主要探讨的是神经肌电图在Ⅱ型糖尿病患者周围神经病变的早期诊断中的价值。方法分析2011年7月至2014年1月在我院治疗的Ⅱ型糖尿病患者的临床资料。入组的Ⅱ型糖尿病患者根据患者的病程进行分组,包括A组(病程>10年)、B组(病程1~10年)和C组(病程<1年)。比较三组患者的临床资料,正中、尺神经、腓总神经的MCV(运动传导速度),SCV(感觉传导速度)以及胫神经H反射和尺神经f波的情况。结果本研究共纳入研究对象180例,其中A组57例,B组65例,C组58例。三组患者的正中神经(χ2=9.104,P=0.011)、尺神经(χ2=9.335,P=0.009)、腓总神经(χ2=9.898,P=0.007)的MCV异常比例均存在着显著的差异,且病程越长,异常率越高;三组患者的正中神经(χ2=13.44,P=0.001)、尺神经(χ2=13.56,P=0.001)、腓总神经(χ2=24.09,P=0.000)的SCV异常比例均存在着显著的差异,病程越长,异常率越高;三组患者胫神经H反射异常比例存在显著的差异(χ2=19.12,P=0.000),且病程越长,异常率越高。而尺神经F波异常比例并无统计学差异(χ2=3.152,P=0.207)。结论Ⅱ型糖尿病患者的病程越长,相应的尺神经、正中神经、腓总神经的MCV、SCV中的异常比例,以及胫神经的H反射异常检出率越高。结合尺神经F波可早期客观检测到糖尿病周围神经病神经近端损害,提高早期诊断。
The purpose of this study is to investigate the value of neuroelectrogram in the early diagnosis of peripheral neuropathy in type 2 diabetic patients. Methods Clinical data of type 2 diabetic patients treated in our hospital from July 2011 to January 2014 were analyzed. Patients with type 2 diabetes mellitus were grouped according to the patient’s duration of disease. Patients were divided into group A (duration> 10 years), group B (duration 1 to 10 years) and group C (duration <1 year). The clinical data of the three groups were compared. The median, ulnar nerve, MCV (motor conduction velocity), SCV (sensory conduction velocity) of the common peroneal nerve and H reflex of tibial nerve and f-wave of ulnar nerve were compared. Results A total of 180 subjects were enrolled in this study, including 57 cases in group A, 65 cases in group B and 58 cases in group C. There were significant differences in the proportion of MCV abnormalities in the median nerve (χ2 = 9.104, P = 0.011), ulnar nerve (χ2 = 9.335, P = 0.009) and common peroneal nerve (χ2 = 9.898, P = 0.007) (Χ2 = 13.44, P = 0.001), the ulnar nerve (χ2 = 13.56, P = 0.001), the common peroneal nerve (χ2 = 24.09, P = 0.000 ) Had a significant difference in the proportion of SCV abnormalities. The longer the course of disease, the higher the abnormality rate. There was a significant difference in the proportion of H reflex abnormalities in the three groups (χ2 = 19.12, P = 0.000) The higher the rate. There was no significant difference in the proportion of F-wave in ulnar nerve (χ2 = 3.152, P = 0.207). Conclusions The longer duration of type II diabetes, the higher the abnormal rates of MCV and SCV in the ulnar nerve, median nerve and common peroneal nerve and the higher incidence of H reflex abnormalities in the tibial nerve. Combined with F-wave of ulnar nerve, early detection of proximal neuropathy in diabetic peripheral neuropathy can be detected objectively and early diagnosis can be improved.