糖尿病末梢神经超声形态学的研究及其临床价值

Study of the peripheral nervous morphology in the diabetic peripheral neuropathy patient and to observe its clinical value

目的探讨糖尿病周围神经病变(DPN)患者足趾神经在高频超声下的形态结构及其在DPN诊断中的价值。方法选择有神经病变症状的2型糖尿病患者150例(观察组)和健康对照组100例。采用高频超声对受试者的足部大拇趾神经直径进行测量,并观察神经的形态结构,同时对受试者进行神经电生理检查。结果采用高频超声能较清楚地显示DPN足趾神经病变的形态结构;高频超声检查和神经电生理检查诊断DPN的灵敏度分别为91.33%和74.67%,特异度分别为91%和82%。足趾神经高频超声检查诊断DPN的灵敏度和特异度均高于神经电生理检查,差异有统计学意义(P<0.01)。结论足部高频超声对DPN患者的诊断有较好的临床价值。

Objective To investigate the size and diversification of peripheral nerve measured by high frequency ultrasound in di-abetic peripheral neuropathy patient .Methods The endings of the medial branch of deep peripheral nerves（DPN） were interrogated by high frequency ultrasound and nerve electrophysiology ,and the nerve conduction characters were studied in a cohort of 150 clini-cally diagnosed diabetic peripheral neuropathy patients and a control group of 100 healthy volunteers .At the sametime these cases underwent electrophysiological examination .Results Distinct echoic appearances were consistently detected between the DPN nerves of diabetic peripheral neuropathy patients and healthy volunteers .The sensitivity rate of high frequency ultrasound and nerve electrophysiological examination in diagnosis of diabetic peripheral neuropathy were 91 .33% and 74 .67% ,and the specificity rate were 91% and 82% .Conclusion High frequency ultrasound may play a role in the diagnosis of diabetic peripheral neuropathy .