早期糖尿病周围神经病患者的EMG改变及其与血清脂蛋白相关磷脂酶A2水平的关系

发布时间：2018-05-01 22:05

本文选题：糖尿病周围神经病 + EMG　；参考：《临床神经病学杂志》2017年05期

【摘要】：目的探讨早期糖尿病周围神经病(DPN)患者的EMG改变及其与血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平的关系。方法对90例早期DPN患者行EMG检查,测定内容包括双侧神经运动传导速度(MCV)、复合肌肉动作电位波幅(CMAP)、感觉传导速度(SCV)、感觉神经动作电位波幅(SNAP)及胫神经H波和尺神经f波,分析其与患者血清Lp-PLA2水平的关系。结果 90例早期DPN患者EMG检查总异常率为90.0%。早期DPN患者下肢运动神经异常率(68.6%)显著高于上肢异常率(24.5%)(χ~2=123.863,P=0.000)。早期DPN患者下肢感觉神经异常率(87.4%)显著高于上肢异常率(54.7%)(χ~2=82.712,P=0.000)。早期DPN患者感觉神经总异常率(71.1%)显著高于运动神经总异常率(46.5%)(χ~2=78.978,P=0.000)。DPN患者胫神经H反射总异常65例(72.2%),尺神经f波总异常14例(15.6%)。根据血清LpPLA2水平,90例早期DPN患者分为低水平组(36例)、中水平组(25例)和高水平组(29例)。与低水平组比较,中水平组及高水平组MCV、SCV异常率及CMAP、SNAP下降率均明显降低,且高水平组MCV、SCV异常率及CMAP、SNAP下降率均明显低于中水平组(均P0.05)。Spearman秩相关分析结果显示,血清Lp-PLA2水平与MCV、SCV异常率及CMAP、SNAP下降率均呈负相关(r=-0.741,r=-0.773,r=-0.652,r=-0.611;均P0.05)。结论 EMG检查对DPN早期诊断有重要价值,维持血清Lp-PLA2水平稳定对早期DPN的治疗可能有重要意义。
[Abstract]:Objective to investigate the changes of EMG in patients with early diabetic peripheral neuropathy and its relationship with the level of serum lipoprotein associated phospholipase A 2 (Lp-PLA 2). Methods EMG examination was performed in 90 patients with early DPN, including bilateral motor conduction velocity (MCV), compound muscle action potential amplitude (CMAP), sensory conduction velocity (SSCV), sensory action potential amplitude (SNP), tibial nerve H wave and ulnar nerve f wave. To analyze the relationship between the serum Lp-PLA2 level and the patients. Results the total abnormal rate of EMG examination in 90 cases of early DPN was 90.0%. The abnormal rate of lower extremity motor nerve in early DPN patients (68.6%) was significantly higher than that in upper limb (24.5%). The abnormal rate of lower extremity sensory nerve in early DPN patients (87.4%) was significantly higher than that in upper limb (54.7%). The total abnormal rate of sensory nerve in early DPN patients (71.1%) was significantly higher than that of motor nerve (46.5%) (蠂 2 / 78.978). The total abnormality of tibial nerve H reflex in 65 cases (72.2%) and ulnar nerve f wave (14 cases) were abnormal in 15.6 cases. According to the serum LpPLA2 level, 90 patients with early DPN were divided into low level group (36 cases) and middle level group (25 cases) and high level group (29 cases). Compared with the low level group, the abnormal rate of MCV P0.05).Spearman and the decrease rate of CMAPN SNAP in the middle and high level groups were significantly lower than those in the middle level group and the high level group. The results of P0.05).Spearman rank correlation analysis showed that the abnormal rate and the decrease rate in the high level group were significantly lower than those in the middle level group, and that in the middle level group and the high level group were significantly lower than those in the middle level group. The levels of serum Lp-PLA2 were negatively correlated with the abnormal rate of SCV in MCV and the decrease rate of SNAP in CMAP. Conclusion EMG is of great value in the early diagnosis of DPN, and maintaining the stability of serum Lp-PLA2 level may be of great significance in the treatment of early DPN.
【作者单位】：江苏大学附属四院神经内一科;
【基金】：镇江市社会发展科技支撑项目(SH2013089,SH2015027)
【分类号】：R587.2;R747.9

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