电流感觉阈值在1型糖尿病周围神经病变早期诊断中的应用价值

发布时间：2018-05-18 20:06

本文选题：1型糖尿病 + 糖尿病周围神经病变　；参考：《苏州大学》2015年硕士论文

【摘要】：目的应用Neurometer CPT/C神经测量仪检测临床确诊1型糖尿病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)的早期诊断提供有效证据。方法完善神经症状评分(NSS)、神经缺陷评分(NDS)及感觉神经传导速度(SCV)检查,选取其中NSS、NDS、SCV均正常且病程小于5年的52例1型糖尿病患者,测定52例患者及40例健康对照组的双侧正中神经、腓肠神经于2000Hz、250Hz、5Hz的CPT值,并检测患者组的糖化血红蛋白、尿微量白蛋白、尿微量白蛋白肌酐比等代谢指标。结果与健康对照组比较,糖尿病组患者双侧正中神经及腓肠神经在各频率下的CPT值均明显降低(P0.01),糖尿病组正中神经损伤数量(左侧8/52,右侧8/52)与同侧腓肠神经损伤数量(左侧28/52,右侧22/52)比较存在显著差异(左右侧均P0.01);糖尿病组中存在DPN组与未发生DPN组比较,DPN组的糖化血红蛋白比未发生DPN组较高(t=2.518,P0.05),运用二元logistic回归发现,高糖化血红蛋白是DPN的一个独立危险因素(OR(95%CI):1.317(1.013-1.712),P0.05)。结论电流感觉阈值(CPT)可以早期发现1型糖尿病发生周围神经病变的高危患者,同时糖尿病周围神经病变中下肢神经较上肢神经易损,发生DPN患者糖化血红蛋白较高,且高糖化血红蛋白是DPN的一个独立危险因素。
[Abstract]:Objective to detect the current sensation threshold of peripheral nerve in type 1 diabetic patients by using Neurometer CPT/C neurometer, and to compare and analyze the extent of the damage of large and small fibers, so as to provide effective evidence for the early diagnosis of diabetic peripheral neuropathy. Methods the neurological symptom score (NSS), nerve defect score (NDS) and sensory nerve conduction velocity (SCV) were improved. Among them, 52 patients with type 1 diabetes with normal NSSN NDSU SCV and less than 5 years course of disease were selected. The CPT values of bilateral median nerve and sural nerve were measured in 52 patients and 40 healthy controls at 2000Hz, 250Hz / 5Hz, and the metabolic indexes such as glycosylated hemoglobin and urinary albumin creatinine ratio were measured. Results compared with the healthy control group, The CPT values of bilateral median nerve and sural nerve in diabetic group were significantly lower than those of control group (left 8 / 52, right 8 / 52) and ipsilateral sural nerve (left 28 / 52, right 22 / 52). There were significant differences between the right and left sides (P 0.01), the glycosylated hemoglobin in the diabetic group with DPN was higher than that in the DPN group (P 0.05). The results were found by binary logistic regression. High glycosylated hemoglobin is an independent risk factor for DPN. Conclusion the high risk patients with peripheral neuropathy in type 1 diabetes can be detected early by current sensing threshold (CPT). The lower extremity nerves of diabetic peripheral neuropathy are more vulnerable than those of upper limb nerves, and the patients with DPN have higher glycosylated hemoglobin. And high glycosylated hemoglobin is an independent risk factor for DPN.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

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