糖尿病性神经病的体感诱发电位分析

Somatosensory Evoked Potential Testing in Diabetic Neuropathy

对26例Ⅱ型糖尿病患者进行体感诱发电位（SEP）检测，以了解其神经病变（DNP）情况。结果：依临床表现诊断有神经并发症患者54％（14／26）；SEP异常76．9％（20／26），其中上肢异常50％（10／20），下肢异常90％（18／20），主要表现为上肢N9和下肢P40潜伏期明显延长，N9平均峰潜伏期男12．3ms，s：0．86，P＜0．001，女分别为11．6ms，0．88．P＜0．002；P40平均峰潜伏期男45．7ms，s：4．55．P＜0．002，女分别为40．24ms，0．79，P＜0．002，与本实验室正常值比较差异有显著性。N9和P40峰潜伏期与患者近期血糖水平呈正相关，相关系数r分别为0．8532和0．5580（P＜0．001），即血糖越高，SEP异常越明显。另外轻症患者仅有波幅降低，重症则有波幅降低并潜伏期延长。提示SEP有助于DNP的诊断，并可了解其类型和程度。DNP早期主要是轴索损害，其后出现髓鞘病变。

Somatosensory evoked potential (SEP) was tested in 26 patients with non-insulin dependent diabetes (NIDD) to study diabetic neuropathy (DNP). Fourteen cases were clinically diagnosed having DNP (54% ), 20 cases were abnormal on SEP (76. 9 % ). Among the 20 cases, SEP following median nerve stimulation were studied in 10 patients (50%) ; SEP following posterior tibial nerve stimulation were studied in 18 patients (90%). In median nerve SEP. the peak latency of N9 showed a significant delay; in posterior tibial nerve SEP. the peak latency of P40 showed a significant delay in comparison with normal values of our laboratory. The mean N9 peak latency of male:12. 3 ms, s: 0. 86. P<0. 001 and of female: 11. 6 ms, s: 0. 88, P<0.002. The mean P40 peak latency of male:45. 7 ms, s: 4. 55, P<0. 002 and of female: 40. 2 ms, s: 0. 79. P<0.002. As Comparing with normal values,there was a significant difference in mean N9 peak latency and mean P40 peak latency. Peak latency of N9 and P40 showed a significant positive correlation with the level of recent blood glucose of the patients with the correlation co-efficient (r) being 0. 8532 and 0. 5580 respectively (P<0.001, one side test). The higher the level of recent blood glucose of the patients was. the more obvious the SEP abnormal, In addition, only amplitude was reduced in the slight disorder, while in the serious cases, both amplitude reduced and peak latency delayed. The findings suggest that SEP may helpful to the clinical diagnosis of DNP and make the circumstance of DNP known to us.