应用MEP、NCV联合诊断糖尿病性神经病

Diagnosis of diabetic neuropathy by motor evoked potentials and nerve conduction velocity

目的 :探讨运动诱发电位 (MEP)、神经传导速度 (NCV)检测对糖尿病 (DM)运动神经中枢及神经根、周围神经病变的诊断价值。方法 :检测 5 0例DM病人的MEP及NCV。结果 :MEP异常率 82 %(4 1/ 5 0 )。表现皮层、脊髓刺激MEP潜伏期延迟、波形分化欠佳 ,部分伴有中枢运动传导时间 (CMCT)异常。MEP异常率与病程长短呈正相关 ;空腹血糖水平对MEP结果无明显影响。NCV异常率 70 % ,主要表现运动神经传导速度 (MCV)、感觉神经传导速度 (SCV)减慢。结论 :MEP、NCV检查对诊断DM的锥体束功能损害及神经根、周围神经病变有重要价值 ,二者结合可对DM的神经系统功能提供全面客观指标。

Objective:To study the diagnostic value of Motor evoked potentials(MEP) and nerve conduction velocity(NCV) in the lesions of motor nerve center,nerve root and peripheral nerve in patients with diabetes mellitus(DM).Methods: MEPs by electrostimulation of cerebral cortex and spinal cord and NCV were performed in 50 patients with DM.Results:The abnormality rate of MEPS was 82%(41/50).The main changes were the prolonged latency and unclear wave form.Central motor conduction time(CMCT) was prolonged in some patients.There was positive correlation between the course of disease and the abnormality rate of MEP.There was no significant relation between the result of MEP and the level of fasting blood sugar.The abnormality rate of NCV was 70%,the main changes were decreased motor conduction velocity(MCV) and sensory conduction velocity(SCV).Conclusions:MEP and NCVmight have an important role in the diagnosis of pyramid tract lesions,nerve root and peripheral nerve lesions,combination of the two methods may provide more complete and objective indexes for function of nevous system in patients with DM.[