肌电图联合糖尿病病程对糖尿病周围神经病变的诊断价值

Value of Electromyography Combined with Diabetes Course in the Diagnosis of Diabetic Peripheral Neuropathy

目的 探究肌电图联合糖尿病病程对糖尿病周围神经病变(DPN)的诊断价值。方法 选取2022年1月至2023年8月在郑州市第二人民医院治疗的86例DPN患者为研究对象,将其设为DPN组;另选取同期在本院治疗的86例单纯糖尿病患者为对照组。比较两组患者基线资料[糖尿病病程、总胆固醇(TG)、糖化血红蛋白(HbA1c)等]及双下肢运动神经传导速度(MCV)、感觉神经传导速度(SCV);采用Logistic回归分析DPN发生的影响因素;采用受试者工作特征曲线(ROC)分析肌电图联合糖尿病病程对DPN的诊断价值。结果 两组糖尿病病程、TG、HbA1c比较,差异有统计学意义(P<0.05),在性别、高血压、吸烟史等其他一般资料比较差异无统计学意义(P>0.05)。与对照组相比,DPN组患者腓总神经的MCV及腓浅神经的SCV值均明显降低(P<0.05)。多因素Logistic回归分析结果显示,糖尿病病程、腓总神经的MCV、腓浅神经的SCV均为糖尿病患者发生DPN的影响因素(P<0.05)。ROC曲线分析显示,腓总神经的MCV、腓浅神经的SCV及糖尿病病程联合诊断DPN的ROC曲线下面积(AUC)为0.899,敏感度为75.6%,特异度为73.3%,三者联合诊断DPN的AUC均明显高于三者单独诊断(P<0.05)。结论 肌电图(腓总神经的MCV、腓浅神经的SCV)与糖尿病病程联合诊断DPN具有较高的诊断价值。

Objective To explore the diagnostic value of electromyography(EMG)combined with the course of diabetes for diabetic peripheral neuropathy(DPN).Methods Eighty-six DPN patients treated in Zhengzhou Second Hospital from January 2022 to August 2023 were included in the DPN group,and 86 patients with simple diabetes treated in the same hospital during the same period were selected as the control group.Baseline data[diabetes course,total cholesterol(TG),and glycosylated hemoglobin(HbA1c),ect.],and motor nerve conduction velocity(MCV)and sensory nerve conduction velocity(SCV)of lower extremities were compared between the two groups.Logistic regression was applied to analyze the influencing factors of DPN in diabetes patients.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of EMG combined with the course of diabetes for DPN.Results There were statistically significant differences in the course of diabetes,TG,and HbA1c between the two groups(P<0.05).There was no statistically significant difference in gender,hypertension,smoking history,and other general data(P>0.05).The MCV of common peroneal nerve and the SCV of superficial peroneal nerve in the DPN group were lower than those in the control group(P<0.05).Multivariate Logistic regression analysis showed that the course of diabetes,MCV and SCV were the influencing factors of DPN in diabetes patients(P<0.05).ROC analysis showed that the area under the ROC curve(AUC)of the combined diagnosis of DPN by MCV of common peroneal nerve,SCV of superficial peroneal nerve and the course of diabetes was 0.899,the sensitivity was 75.6%,and the specificity was 73.3%.And the AUC of the combined diagnosis of the three methods for DPN was significantly higher than that of each alone(P<0.05).Conclusion The combination of MCV of common peroneal nerve,SCV of superficial peroneal nerve and the course of diabetes has high value in the diagnosis of DPN.