感觉定量和神经传导速度联合检测对糖尿病周围神经病的诊断价值

Diagnosis value of detection of sensory quantitative combined with nerve conduction velocity to diabetic peripheral neuropathy

目的:探讨感觉定量检测(QST)、神经传导速度检测(NCV)联合应用对糖尿病(DM)周围神经病(PNP)的诊断价值。方法:对37例DM患者进行常规NCV检测;并且对这37例DM患者和20例正常人进行QST检测。结果:在37例DM患者中,QST异常32例(86％),与对照组比较差异有极显著意义(P<0．001);NCV检测异常23例(62％),与正常值对照差异有极显著意义(P<0．001)。这两种检测方法阳性率对比,差异亦有统计学意义(P<0．05)。结论:NCV可作为DM-PNP的常规检测方法,但NCV仅能反映粗有髓神经纤维的功能,阳性率低,而QST可反映细神经纤维的功能,且操作简便,无创伤,无痛苦,老年人易接受。两种方法联合使用可提高DM患者PNP的检出率,为DM-PNP的诊断提供有力依据,也可作为治疗及预后观察的客观指标。

Objective：To explore the diagnosis value of quantitative sensory testing （QST） combined with nerve conduction velocity （NCV） to diabetes mellitus peripheral neuropathy（DM PNP） Methods： Routine detected NCV to 37 the diabetics, and detected QST to 37 diabetics and 20 normal peoples. Result：In 37 diabetics , QSTs are abnormal in 32 cases （86%） and there is a remarkable significance in contrast to the control group （P〈0. 001）. NCV are abnormal in 23 cases（62% ）. The positivity rates of the two detection methods have a significant difference too （P〈0. 05）. Conclusion： NCV could be applied as a routine detection method to patients with DM-PNP, but can only reflect the funtion of thick nerve fibres, and its posilivity rate is low. But QST can reflect the function of the thin nerve fibres, and it is easy and simple to handle , without wound and agony , which the elderly are easy to accept. Combination of the two methods can increase the detected rate of peripheral neuropathy of diabetic patients, can be as regarded as the objective index of treated and prognosis observes.