超声检测糖尿病患者正中神经改变的临床价值

Clinical value of ultrasonography in detection of median nerve in diabetic patients

目的探讨超声检测糖尿病患者正中神经改变辅助糖尿病周围神经病变（DPN）的诊断价值。方法采用高频彩色多普勒超声观察43例2型糖尿病患者（糖尿病组）及70例健康志愿者（对照组）的正中神经形态学及血流信号改变，在腕管处测量正中神经横截面积，并进行比较。其中糖尿病组根据病程分为病程〈10年组26例和病程≥10年组17例，根据入院时随机血糖（RPG）分为RPG〈15mmol／L组28例和RPG≥15mmol／L组15例。结果与对照组比较，糖尿病组正中神经回声减低，彩色血流信号增多。糖尿病组正中神经横截面积高于对照组[（10．3±2．1）mm。比（8．3±1．7）mm2]，病程≥10年组正中神经横截面积高于病程〈10年组[（12．3±2．0）mm。比（10．2±2．6）mm2]，RPG≥15mmol／L组正中神经横截面积高于RPG〈15mmol／L组[（11．7±1．8）mm。比（9．6±2．7）mm2]，差异均有统计学意义（P值均〈0．01）。结论超声能客观反映2型糖尿病患者正中神经的形态学改变，为DPN提供诊断依据。

Objective To explore the clinical value of ultrasonography in the detection of median nerve in diabetic peripheral neuropathy （DPN）. Methods Median nerve was detected in 70 healthy adults （control group） and 43 patients with type 2 diabetes mellitus （diabetes meUitus group） by color Doppler ultrasonography. The type 2 diabetes mellitus patients were divided into two groups according to the duration of the disease： 〈 10 years group （26 cases） and ≥ 10 years group（ 17 cases）. And they were divided into two groups according to the random plasma glucose （RPG） ：RPG 〈 15 mmol/L group （28 cases） and RPG≥15 mmol/L group （ 15 cases）, The nerve cross section area （CSA） was taken at the level of the pisiform. Results The median nerve in diabetes mellitus group had decreased echogenicity and increased color in it. The CSA of the median nerve in diabetes mellitus group was significantly higher than that in control group [ （ 10.3 ± 2.1 ） mm2 vs. （8.3± 1.7） mm2]（P 〈 0.01 ）. The CSA of the median nerve in t〉 10 years group was significantly higher than that in 〈10 years group [ （ 12.3 ± 2.0） mm2 vs. （ 10.2 ± 2.6） mm2] （P 〈 0.01 ）. The CSA of the median nerve in RPG ≥ 15 mmol/L group was significantly higher than that in RPG 〈 15 mmol/L group [ （ 1 1.7 ± 1.8） mm2 vs. （9.6 ±2.7 ） mm2]（P 〈 0.01 ）. Conclusion Color Doppler uhrasonography examination may reveal morphology of median nerve and is useful for the diagnosis of DPN.