糖尿病周围神经病患者上肢受累神经的分布特点的研究分析

Research and Analysis of Distribution Features of Nerves of Upper Extremity in Diabetic Peripheral Neuropathy

目的探讨糖尿病周围神经病(DPN)患者不同上肢神经受累情况及分布。方法将62例糖尿病周围神经病患者纳入DPN组,62例无周围神经病的糖尿病患者纳入对照组,采用肌电/诱发电位仪检测所有患者上肢正中神经、尺神经、桡神经的感觉神经传导速度(SCV)、感觉神经传导波幅(SNAP)、运动神经传导速度(MCV)、复合肌肉动作电位波幅(CAMP),比较不同组别、不同神经的传导指标。结果 DPN组正中神经、桡神经、尺神经SCV均显著低于对照组[(40.5±3.9)m/s vs(54.3±4.3)m/s]、[(44.2±4.8)m/s vs(51.2±5.8)m/s]、[(46.1±4.0)m/s vs(53.3±6.1)m/s](P<0.05);DPN组正中神经、桡神经、尺神经MCV均显著低于对照组[(45.6±5.5)m/s vs(54.3±4.2)m/s]、[(48.5±3.9)m/s vs(55.0±5.1)m/s]、[(48.9±4.6)m/s vs(53.1±4.8)m/s](P<0.05)。正中神经感觉神经异常率、运动神经异常率均显著高于尺神经、桡神经(P<0.05),尺神经、桡神经感觉神经异常率、运动神经异常率无统计学意义(P>0.05);正中神经感觉神经异常率均显著高于运动神经(P<0.05)。结论 DPN患者神经传导速度显著降低,上肢神经以正中神经受累最为严重,而感觉神经受累多于运动神经。

Objective To investigate conditions and distribution of upper extremity nerves involved in diabetic peripheral neuropathy（DPN） patients. Methods A total of 62 patients with DPN admitted to Boye County Hospital were included in DPN group, and 62 diabetes patients without peripheral neuropathy were included into the control group EMG/evoked potentials were used to detect sensation conduction velocity （ SCV ）, sensory nerve conduction amplitude （ SNAP）, motor conduction velocity （ MCV ）, compound muscle action potential amplitude（CAMP） of median nerve,ulnar nerve,radial nerve of all patients. Then indicators of different groups, different nerve conductions were compared. Results SCV of median nerve, ulnar nerve, radial nerve of DPN group were significantly lower than the control group[ （ 40.5 ± 3.9 ） m/s vs （ 54.3 ± 4.3） m/s],[（44.2 ±4.8） m/svs （51.2±5.8） m/s],[（46.1 ±4.0） m/svs （53.3±6.1） m/s]（P 〈 0.05 ） ; MCV of median nerve, ulnar nerve, radial nerve of DPN group were significantly lower than the control group [ （45.6 ± 5.5 ） m/s vs （54.3 ± 4.2 ） m/s ], [ （ 48.5 ±3.9 ） m/s vs （ 55.0 ± 5.1 ） m/s ], [ （48.9 ± 4.6 ） m/s vs （ 53.1 ± 4.8 ） m/s ] （ P 〈 0.05 ）. Abnormal rates of median nerve sensory nerve, motor nerve were significantly higher than the ulnar nerve, radial nerve （P 〈 0.05 ）, while there was no significant difference in abnormal rate between ulnar nerve and radial nerve （ P 〉 0.05 ） ; sensory nerve abnormal rates of median nerve were significantly higher than motor nerves （ P 〈 0.05 ）. Conclusion Nerve conduction velocity of patients with DPN is significantly reduced, and the involvement of median nerye is most serious among upper extremity nerves, and sensory nerve is more serious than motor nerves.