摘要
目的:探讨糖尿病性神经病的电生理改变特征。方法:在60例Ⅱ型糖尿病患者中,有神经病学症状或体征的29例为A组,无神经病学症状或体征的31例为B组。C组为正常对照。在三组中测定腓总神经运动神经传导速度(MCV),远端潜伏期(DPL),复合肌肉动作电位(CMAP)的波幅、时限,检测数据进行t检验。结果:A组与B、C组分别对比,A组MCV减慢(72%),DPL延长(55%),CMAP波幅降低(34%)、时限延长(52%),有显著差异(P<0.01)。B组与C组对比,B组CMAP波幅降低,有显著差异(P<0.05),B组16%DPL延长,对7%CMAP时限延长。各组内远端与近端刺激引出的CMAP波幅、时限对比均无显著差异(P>0.05)。A组电生理异常率为100%,B组为23%。A组病程长但血糖水平同B组相近。结论:了解腓总神经的电生理改变有助于评价糖尿病性远端神经病与临床病程、进展的关系。
Objective:To study the charactersistic of electrophsiological changes in diabetic neuropathy.Method :Sixty patients with NIDDM were divided into group A(29 cases with neurologic symptoms or signs) and groupB (31 cases without neurologic symptoms or signs). Group C served as a control group. The peroneal motor conductionvelocity (MCV), distal potential latency(DPL), amplitude and duration of the compound muscle action potential(CMAP) were determined in the be groups. Results: Compared with group B and C, group A showed decreasedMCB(72% ), prolonged M(55% ),reduced amplitude of CMAP (34% ), prolonged duration of CMAP (52% ),there was a significant difference (P < 0.001 ). Group B showed significant reduced amplitude of CMAP, prolongedDPL(16% ) and CMAP(7% ) (P < 0.05) as compared with group C. In three groups themselves, the amplitude andduration of CMAP induced by stimulation at the near end and the distal were compared with each other, there was nosignificant difference(P > 0.05) between them. The abnormality rate of electrophysiology was 100% in group A and23% in group B.The average course of disease in group A is longer than that in group B, but the two groups have thesame blood glucose level. Conclusions: To know the electrophysiological changes of peroneal might be helpful to evaluatethe relationship between diabetic distal neuropathy and diabetic duration and development.