糖尿病周围神经病交感神经皮肤反应电位曲线下面积研究

The Diagnosis Study of Area under Curve of Sympathetic Skin Response in Diabetic Peripheral Neuropathy

目的探讨交感神经皮肤反应电位(SSR)曲线下面积对糖尿病周围神经病(DPN)的诊断价值。方法 100例糖尿病患者中,有DPN临床表现的57例为A组,无DPN临床表现的43例为B组,C组35例为正常对照组。3组均行双上肢交感皮肤反应(SSR)检测,对SSR起始潜伏期、波幅、曲线下面积3个参数进行统计学处理。结果双肢或单肢未引出SSR者,A组为29例(50.9%),B组为14例(32.6%),A、B两组差异有统计学意义(P<0.01)。A组与C组对比,A组双侧潜伏期延长(P<0.05)、波幅降低(P<0.01)、曲线下面积减少(P<0.01)。B组与C组对比,B组右侧潜伏期延长(P<0.05)、双侧波幅降低(P<0.05)、双侧曲线下面积减少(P<0.05)。A、B两组曲线下面积的异常率均高于起始潜伏期和波幅。结论 SSR是DPN早期诊断的有效方法,曲线下面积可作为敏感指标,有助于发现亚临床病变。

Objective To explore the diagnosis value of area under curve of sympathetic skin response （SSR） in diabetic peripheral neuropathy. Methods 100 patients with NIDDM were divided into group A （57 cases with neurologic symptoms or signs） and group B （43 cases without neurologic symptoms or signs）.Group C （35 cases） was served as a control group. The onset latency, amplitude, area under the curve of SSR of all subjects were detected and analyzed, Results There SSR of double or single-limb were not elicited in 29 patients （50.9%） of group A, and in 14 patients （32.6%） of group B. There was significant differences between group A and group B （P〈0.01）. Compared with group C, group A had longer latency, lower amplitude and less area under the curve of SSR in double hands （P〈0.01）; Group B had longer latency of SSR compared with group C in right hand （P〈0.05）, had lower amplitude and less area under the curve of SSR than group C did in double hands （P〈0.05）. The abnormal rate of area under the curve was significantly higher than that of the latency and amplitude. Conclusion SSR can early detect subclinical DPN, the area under the curve of SSR is particularly sensitive for early diagnosis of DPN.