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目的应用Neurometer~(?)CPT/C神经测量仪检测临床确诊T1DM患者周围神经的电流感觉阈值(CPT),对比分析大小纤维受损的程度,从而为糖尿病周围神经病变(DPN)早期诊断提供有效证据。方法测定52例T1DM(T1DM)患者及40名正常对照(NC)者双侧正中神经、腓肠神经2000、250、5 Hz CPT,并检测两组HbA_1 c、尿白蛋白/肌酐(UAlb/Cr)等代谢指标。结果与NC组比较,T1DM组双侧正中神经及腓肠神经2000、250、5 Hz频率下CPT降低(P<0.05);T1DM组正中神经损伤数量与同侧腓肠神经损伤数量比较,异常率偏低(左侧x~2=16.99,P<0.01;右侧x~2=10.34,P<0.01);T1DM组CPT正常亚组与CPT异常亚组HbA_1c水平比较,差异无统计学意义。二元Logistic回归分析显示,高HbA_1c是发生DPN的独立危险因素。结论 CPT可以早期发现T1DM患者周围神经受损,同时DPN下肢神经较上肢神经易损,DPN患者HbA_1c较高,且高HbA_1c是DPN的独立危险因素。
Objective To detect the current sensory threshold (CPT) of peripheral nerves in clinically diagnosed T1DM patients by using the Neurometer CPT / C nerve measuring instrument, and to compare the extent of the impaired fibers with that of the diabetic patients, so as to provide an effective early diagnosis of diabetic peripheral neuropathy (DPN) evidence. Methods 52 cases of T1DM (T1DM) and 40 normal controls (NC) were examined by bilateral CPN at 2000,250 and 5 Hz. The HbA 1 c, UAb / Cr ) And other metabolic indicators. Results Compared with NC group, the CPT of bilateral median nerve and sural nerve at 2000, 250 and 5 Hz were lower in T1DM group (P <0.05). The number of median nerve injury and the number of ipsilateral sural nerve injury in T1DM group were significantly lower than those in NC group (Left side x ~ 2 = 16.99, P <0.01; right side x ~ 2 = 10.34, P <0.01). There was no significant difference in the level of HbA 1c between the CPT normal subgroup and CPT abnormal subgroup in T1DM group. Binary logistic regression analysis showed that high HbA_1c was an independent risk factor for DPN. Conclusion CPT can early detect peripheral nerve damage in patients with T1DM, while lower extremity nerves in DPN are more vulnerable to upper extremity nerves. HbA_1c is higher in patients with DPN, and higher HbA_1c is an independent risk factor for DPN.