糖尿病周围神经病变筛查方法的临床研究

Clinical studies of diabetic peripheral neuropathy screening process

目的:探讨糖尿病周围神经病变(DPN)筛查流程的诊断价值,寻找经济、简便、快捷、准确的DPN筛查方法。方法:河南省人民医院糖尿病患者452例,对其进行神经肌电图和DPN的筛查。以神经肌电图作为"金标准",分析DPN筛查方法的敏感度、特异度、阳性预测值、阴性预测值和约登指数。结果:DPN中有症状组占69.91%,以神经肌电图检查为标准,DPN的灵敏度、特异度、阳性预测值、阴性预测值和约登指数分别为89.43%、63.09%、80.38%、78.0%和0.52。DPN筛查具有较高的灵敏度和特异度,适应在DPN早期临床筛查中应用。糖尿病患者存在着不同的DPN症状,以麻木最多。压力觉的灵敏度和特异度为19.44%和95.62%;振动觉的灵敏度和特异度为77.78%和60.87%;温度觉的灵敏度和特异度为35.19%和89.13%;针刺觉的灵敏度和特异度分别31.48%和84.78%。完成DPN表平均耗时5.89 min。结论:DPN筛查流程适应在DPN早期临床筛查中应用。

Objective： To evaluate the application value of DPN screening process for DPN in the diagnosis and look for a economical,simple,fast,accurate way for DPN screening.Methods： To collect a total of 452 cases of diabetes,each patient was performed electroneuromyogyaphy and DPN at the same time.Compared the diagnostic value of DPN screening process while taken electroneuromyogyaphy as a ＂gold standard＂ to calculate this kind of screening sensitivity,specificity,positive predictive value,negative predictive value and Youden index.Results： 316 patients were positive diagnosed with DPN process（accounting for 69.91%）.Sensitivity,specificity,positive predictive value,negative predictive value and Youden index of DPN were 89.43%,63.09%,80.38%,78.00% and 0.52 respectively.Diabetic patients had different symptoms of DPN,Numbness was the most common.Sensitivity and specificity of feeling the pressure were 19.44% and 95.62%.Vibration perception sensitivity and specificity were 77.78% and 60.87%,temperature sensation of the sensitivity and specificity were 35.19% and 89.13%,pinprick sensitivity and specificity were 31.48% and 84.78%.DPN screening process took an average of 5.89 minutes.Conclusion： DPN screening process has economical,simple,fast,accurate feature,Which could be used for diabetic peripheral neuropathy in patients with early clinical screening.