Ⅱ型糖尿病患者多项神经电生理的研究

THE STUDY ON MULTI-NEUROELECTROPH-YSIOLOGY IN TYPE Ⅱ DIABETIC PATIENTS

目的：为了评估Ⅱ型糖尿病（ＤＭ）患者亚临床神经系统的病变。方法：本文通过对４７例无神经系统病变症状与体征的Ⅱ型糖尿病患者和３０例健康体检者，同时进行了听觉脑干诱发电位（ＢＡＥＰ）、视觉诱发电位（ＶＥＰ）和周围感觉神经传导速度（ＳＣＶ）的测定。结果：ＤＭ组ＢＡＥＰ的波峰间期（ＩＰＬ）和ＶＥＰ的Ｐ１００潜伏期较对照组均明显延长，有统计学上的差异（Ｐ＜０．０５）；ＤＭ组的ＳＣＶ较对照组显著减慢（Ｐ＜０．０５）。其中ＤＭ组ＢＡＥＰ的Ｉ～ＶＩＰＬ异常率为７０．２１％，ＶＥＰ的Ｐ１００潜伏期异常率为６３．８３％。两者较ＳＣＶ异常率（２５．５３～３４．０４％）为高（Ｐ＜０．０１）。结论：Ⅱ型ＤＭ患者早期已存在广泛的亚临床神经病变，ＢＡＥＰ、ＶＥＰ和ＳＣＶ是早期诊断ＤＭ亚临床神经系统病变重要手段，其中ＢＡＥＰ的Ｉ～ＶＩＰＬ和ＶＥＰ的Ｐ１００为最敏感的诊断指标。

Objective:To evaluate subclinical nervous system complications in type Ⅱ diabetic patients.Methods:The brainstem auditory evoked potential (BAEP),Visual evoked potential (VEP) and peripheral sensory nerve conduction velocity (SNCV) were detected in 47 type 2 diabetic patients of no clinical nervous system complications and 30 healthy controls.Results:Interpeak Latency (IPL) of BAEP and Latency of P100 were significantly prolonged in type 2 diabetic patients comparing with those in healthy controls (P<0.05) ;the SNCV of the type 2 diabetic patients were significantly slower than those of healtly controls (P<0.05);the abnormal ratio of I～V IPL and Latency of P100 were 70.21% and 63.83% respectively,were significantly higher than those of SNCV (25.53～3404)% in type 2 diabetic patients (P〗<0.01). Conclusion:The type 2 diabetic patients have had multilatery subclinical nerves system complications in early phase.BAEP、VEP. and SNCV are all important methods in early diagnosing subclinical nervous system complications,but I～VIPL and latency of P100 are most sensitive diagnostic index.