不同民族糖尿病早期周围神经病的临床与神经电生理分析

Clinical and Electrophysiological Analysis of Early Diabetic Peripheral Neuropathy in Different Nationalities

目的本研究初步探讨汉族、回族、锡伯族糖尿病早期周围神经病变患者的临床及神经电生理检查的特点。方法2013年1月-2016年6月就诊新疆自治区伊犁州友谊医院神经内科并首次确诊为糖尿病早期周围神经病患者300例(汉族、回族与锡伯族各100例)。结果 1.锡伯族患者压力觉减退及震动觉减退比例显著高于汉族及回族,并有统计学差异(P=0.008,P=0.000)。2.三组患者运动神经传导结果:下肢波幅异常比例显著高于上肢,其中以腓总神经波幅异常比例最高(22%、26%、33%);锡伯族尺神经波幅异常比例高于汉族及回族(P=0.002),锡伯族尺神经及腓总神经波幅下降程度均高于汉族及回族(P=0.000及P=0.027)。3.三组感觉神经波幅异常率均重于运动神经:汉族:29.5%(118/400)vs.14%(56/400),P=0.000回族:28.3%(113/400)vs.13.8%(55/400),P=0.000;锡伯族:35.8%(143/400)vs.21.5%(86/400),P=0.000;结论汉族、回族、锡伯族糖耐量异常合并周围神经病变患者的临床及神经电生理表现均以感觉神经受损为主,锡伯族临床及神经电生理检查表现程度较为严重。

Objective To study the clinical and neurophysiological features of peripheral neuropathy in Han Hui and Sibe patients with impaired glucose tolerance. Methods The clinical data of 300 patients（Han Hui and Sibe）with peripheral neuropathy who first diagnosed impaired glucose tolerance underwent nerve conduction study during Jan 2013 to Jun 2016 were retrospectively analyzed.Results 1. The percentage of pressure abatement, hypopselaphesia were significantly higher than that of Han and Hui group（P=0.008,P=0.000）. 2.The results of motor nerve in three group： Amplitude abnormality was more severe in lower limbs than that of upper limbs and the highest prevalence in Peroneal nerve（22%,26%,33%）; amplitude abnormality in Ulnar nerve in Sibe group was significantly higher than that of Han and Hui group（P=0.002）, the abnormal degree in amplitude was higher than that of in Han and Hui group（P=0.000,P=0.027）. 3.The abnormal degree were more severe in sensory nerve than that of in motor nerve in Han, Hui, Sibe group：29.5%（118/400）vs.14%（56/400）, P=0.000, 28.3%（113/400）vs.13.8%（55/400）, P=0.000, 35.8%（143/400）vs.21.5%（86/400）, P=0.000, respectively.Conclusion The most common clinical, electrophysiological manifestation of peripheral neuropathy in impaired glucose tolerance patients is sensory disturbance, which is more severe in lower limbs and in Sibe population