单纤维肌电图对糖尿病周围神经病的诊断价值

Diagnostic value of single fiber electromyography in diabetic peripheral neuropathy

目的 探讨单纤维肌电图 (SFEMG)在糖尿病周围神经病 (DPN)中的应用。方法 采用 Viking 肌电图仪 ,测定 36例 2型糖尿病患者指总伸肌的颤抖和纤维密度 (FD) ,同时进行常规神经传导检测(NCS)并测量空腹血糖和糖化血红蛋白 (Hb A1 C)。结果 颤抖和 FD具有相关性 ,且均与 Hb A1 C呈正相关。 18例 NCS异常者 ,颤抖值均超出正常范围 (11例伴阻滞 ) ,14例 FD增加 ;18例 NCS正常者 ,7例颤抖值增大 (3例伴阻滞 ) ,5例 FD增加。结论 颤抖和 FD所反映的失神经 -神经再支配与代谢状况相关联 ;SFEMG是DPN早期诊断的敏感手段 ,可发现糖尿病亚临床周围神经病变。

Objective To study the diagnostic value of single fiber electromyography (SFEMG) in diabetic peripheral neuropathy (DPN).Methods The values of jitter and fiber density (FD) in 36 patients with diabetes mellitus of 2 type were determined by Viking Ⅳ, while conventional nerve conduction studies (NCS) were performed,and the fasting blood glucose and glycosylated hemoglobin A 1C (HbA 1C ) were measured.Results The values of jitter were associated with FD, and both jitter and FD were positively related to HbA 1C .18 cases with abnormal NCS showed increased jitter(11 cases with block),and increased FD in 14 cases; the remaining 18 cases with normal NCS,7 cases with increased jitter(3 cases with block),the increased FD in 5 cases.Conclusion Denervation reinnervation reflected by jitter and FD was associated with the metabolic status. SFEMG could be served as sensitive means to early diagnosis of DPN, and might detect subclinical peripheral neuropathy of diabetes.