摘要
目的:探讨接触性热痛诱发电位(CHEP)在评价糖尿病(DM)患者三叉神经功能状态中的应用价值。方法:应用CHEP刺激器对46例DM患者以及20例健康志愿者(对照组)一侧眉弓进行刺激,CZ点记录CHEPN波潜伏期及N-P波波幅,同时行同侧的瞬目反射(BR)及面神经直接反应检测。DM患者根据正中神经、尺神经、胫后神经、腓总神经传导结果分为神经传导异常(DMA)组33例与神经传导正常(DMN)组13例。结果:DM组与对照组CHEPN波潜伏期分别为(382.7±36.8)ms和(342.2±20.8)ms,差异有统计学意义(t=5.465,P<0.001),N-P波波幅对数值分别为1.66±0.21和1.84±0.24,差异有统计学意义(t=2.922,P=0.005);2组BR的R1、R2、R2潜伏期、R/D值差异均无统计学意义;DMN组较对照组CHEPN波潜伏期延长;DMA组较DMN组N-P波波幅对数值减低。结论:糖尿病三叉神经小纤维在BR及大的有髓纤维神经传导正常阶段即可受损,CHEP对评价DM患者颅神经小纤维功能状态具有潜在的临床应用价值。′
Objective： To investigate the application value of the contact heat
evoked potential （CHEP） for the trigeminal small-fiber dysfunction in patients
with diabetes mellitus （DM）. Methods： The heat stimuli were delivered to the skin
above the eyebrow with a contact heat stimulator in 46 diabetic patients, and 20
healthy volunteers were as control. The peak latency of the negative component and
the peak-to-peak amplitude of CHEP were recorded at the vertex （Cz）. The blink
reflexes （BR） and direct electrical stimulation of the facial nerve were performed
in the same side of patients. The patients with diabetes mellitus were divided
into the group with normal conduction （DMN group, n=33） and the group with
abnormal conduction （DMA group, n=13） according to the results of the nerve
conduction of the limbs. Results： The values of peak latency were （382.7±36.8） ms
vs （342.2±20.8） ms in DM group and control group （t = 5.465,P 〈 0.001） and the
values of negative component of CHEP were （1.66±0.21） vs （1.84±0.24） （t = 2.922,
P = 0.005）. There were no statistical differences in latencies of R1, R2 and R2 of
BR and R/D ratio （the latency of R1/the latency of direct electrical stimulation
of the facial nerve） between two groups. The peak latency of the negative
component of CHEP was longer in DMN group than that of the control group. The
common logarithm of the peak-to-peak amplitude of CHEP was lower in DMA group than
that of DMN group. Conclusion： The trigeminal small-fiber dysfunction may occur
when BR or nerve conduction of the large myelinated nerve was normal. CHEP has
potential clinical application value in the evaluation of the small-fiber function
of cranial nerve in patients with diabetes mellitus.
出处
《天津医药》
CAS
北大核心
2011年第6期505-507,共3页
Tianjin Medical Journal
关键词
糖尿病神经病变
糖尿病
三叉神经
诱发电位
眨眼
diabetic neuropathies diabetes mellitus trigeminal nerve evoked potentials blinkin
