糖尿病周围神经病变患者的电生理检查结果及患病危险因素分析

The electrophysiological examination and risk factors of the diabetic peripheral neuropathy

目的观察糖尿病周围神经病变（DPN）的电生理检查结果 ,分析患病危险因素。方法 354例T2DM患者均行神经传导速度（NCV）和皮肤交感反应（SSR）检测,根据结果分为合并DPN（DPN）组228例与未合并DPN（NDPN）组126例。比较两组一般资料、生化指标及糖尿病并发症发生率。采用Logistic回归分析DPN的危险因素。结果 NCV联合SSR检出DPN的异常率较单独应用NCV或SSR高（64.4%vs56.2%vs 32.8%,χ^2=76.401,P=0.000）;DPN组年龄、糖尿病病程、2 hPG、DR和糖尿病慢性肾脏疾病（CKD）患病率均高于NDPN组（P〈0.05）;年龄、糖尿病病程、合并DR是T2DM合并DPN的独立危险因素（P〈0.05）。结论 NCV与SSR联合应用可提高DPN的检出率;高龄、糖尿病病程长、合并DR均可导致T2DM并发DPN的风险增加。

Objective To research the electrophysiological examination of diabetic peripheral neuropathy（DPN） and its risk factors.Methods 354 patients with type 2 diabetes（T2DM） were divided into DPN（n=228） group and non-DPN group（NDPN,n=126） according to the results of NCV and SSR examinations.The differences of clinical factors,biochemistry indexes and complications such as diabetic retinopathy（DR） and chronic kidney disease（CKD） between the two groups were compared.Logistic regression was used to analyze the risk factors for DPN.Results（1） The diagnosis rate of DPN using NCV combined with SSR（64.4%） was higher than using NCV（56.2%） or SSR（32.8%） alone（P〈0.05）.（2） Age,duration of T2 DM,2 hPG.and the rates complicated with DR and CKD were higher in T2 DM with DPN than those without DPN（P〈0.05）.（3） Age（P = 0.043,OR =1.024,95%CI：1.001-1.047）,duration of T2DM（P=0.045,OR=1.039,95%CI：1.001 ~ 1.079） and DR（P=0.008,QR=1.997,95%CI：1.200~3.323） were independent risk factors of DPN.Conclusion NCV combined with SSR is beneficial to increase the diagnostic level of DPN.Age,long duration of T2 DM and DR are independent risk factors of DPN.