10g单丝在糖尿病周围神经病变筛查中的价值

Value of 10g monofilament for screening of diatetic peripheral neuropathy

目的探讨10g单丝在糖尿病周围神经病变(diabetic peripheral neurophathy,DPN)筛查中的价值。方法选取2型糖尿病患者161例进行神经传导速度(nerve conduction velocity,NCV)检查和10g单丝检查,计算10g单丝诊断DPN的敏感度、特异度、准确度、阳性预测值、阴性预测值、约登指数。结果 10g单丝检查≥1分判断DPN阳性率为26.7%(43/161);10g单丝检查≥2分判断DPN阳性率为20.5%(33/161);10g单丝检查≥3分判断DPN阳性率为13.0%(21/161)。以NCV检查为金标准,评价10g单丝检查≥1分、10g单丝检查≥2分和10g单丝检查≥3分的敏感度、特异度、准确度、阳性预测值、阴性预测值、约登指数。结果显示10g单丝检查≥1分的敏感度、准确度、阴性预测值、约登指数最高,可靠性最好。结论 10g单丝检查≥1分可以作为糖尿病患者筛查DPN的可靠方法,其在DPN早期临床筛查中具有很好的应用价值。

Objective To assess the value of 10 g monofilament test in the diagnosis of diabetic peripheral neuropathy（DPN）.Methods The study was made on the clinical data of 161 type 2diatetic patients who underwent nerve conduct velocity（NCV）examination and 10 g monofilament test.The sensitivity,specificity,accuracy,positive and negative predictive values and Youden index were analyzed for 10 g monofilament test.Results The positive rate of 10 g monofilament test≥1,≥2,≥3for DPN screening was 26.7%（43/161）,20.5%（33/161）,13.0%（21/161）,respectively.The outcomes of NCV were taken as the golden standard,and the sensitivity,specificity,accuracy,positive and negative predictive values and Youden index were analyzed for the score of 10 g monofilament test≥1,≥2,≥3respectively,and the result showed that 10 g monofilament test≥1had the best reliability of DPN screening.Conclusion The score of 10 g monofilament test≥1is a reliable method for DPN screening of diabetic patients,and can be well applicable in clinical screening for DPN.