糖尿病感觉神经病患者的运动单位数目估计

Motor unit number estimation in patients with diabetic sensory neuropathy

目的通过运动单位数目估计技术检测糖尿病感觉神经病患者运动单位，以期评估其下运动神经功能状态。方法纳入54例符合世界卫生组织糖尿病周围神经病国际协作研究诊断标准的糖尿病周围神经病（DPN）住院患者，并根据尺神经传导异常结果分组：感觉异常组（即仅有感觉传导异常而运动传导正常）33例，其中男20例，女13例；感觉运动异常组（即感觉传导和运动传导均异常）21例，其中男13例，女8例，并与42名健康人对照。应用Keypoint4肌电诱发电位仪，计数各组小鱼际肌运动单位数目，同时记录54例DPN患者入院后糖尿病病程和空腹血糖。结果感觉异常组、感觉运动异常组和健康对照组的小鱼际肌运动单位数目分别为97．1±47．6、63．3±22．3、173．0±75．5（F=21．259，P=0．000）；54例DPN患者小鱼际肌运动单位数目（84．0±42．8）与糖尿病病程（1个月至26年）呈负相关（r=-0．414，P=0．002），与空腹血糖水平（5．0～20．4mmol／L）无明显相关。结论糖尿病感觉神经病存在着临床下运动神经损害，运动单位的丢失程度受糖尿病病程的影响。

Objective To evaluate the function of motor nerve in patients with diabetic sensory neuropathy （DPN） by estimating the motor units. Methods Fifty-four patients with DPN were divided into two groups according to the nerve conduction abnormality of ulnar nerve. The paresthesia group only included patients of 33 patients （20 male, 13 female） with abnormal sensory conduction. The admixture group included 21 patients （13 male, 8 female） with abnormal motor sensory conduction. The control group included 42 healthy people. A Keypoint4 electromyogram device was used to estimate the motor units of hypothenar muscle, and the fasting blood glucose and the duration of diabetes mellitus were documented. Results The motor units of hypothenar muscle in paresthesia group, admixture group and control group was 97. 1 ± 47.6, 63.3 ± 22. 3, 173.0 ± 75.5 （ F = 21. 259, P = 0. 000） respectively. The hypothenar muscle motor units （ 84. 0 ± 42. 8 ） in 54 patients with DPN had negative correlation （ r = - 0. 414, P = 0. 002 ） with the duration of diabetes mellitus （ 1 month to 26 years） and had no evident correlation with fasting blood glucose （5.0--20.4 mmol/L）. Conclusion There is clinical motor nerve damage in patients with diabetic sensory neuropathy, and the loss of motor units is impacted by the duration of diabetes mellitus.