超声评估Ⅱ型糖尿病患者胫神经改变与密歇根筛查量表评分的关系

The relationship between tibial nerve changes and Michigan screening scale score in patients with type Ⅱ diabetes mellitus: an ultrasonographic study

目的探讨Ⅱ型糖尿病患者胫神经的超声改变特征与密歇根筛查量表评分的关系。方法对139例糖尿病患者和25例正常人为对照组进行胫神经超声检查,依据密歇根筛查量表评分对入选的糖尿病患者进行如下分组:<1分组,1~2分组,2~3分组,3~4分组,>4分组,测量胫神经左右径、前后径和横截面积,比较不同密歇根筛查量表评分间年龄、性别、胫神经左右径、前后径和横截面积差异,分析胫神经左右径、前后径和横截面积与密歇根筛查量表评分的相关性。结果 1~2分组胫神经左右径与<1分组差异无统计学意义(P>0.05)。任意两组间的胫神经左右径、胫神经前后径和横截面积差异均有统计学意义(P<0.05),且糖尿病患者的胫神经左右径、胫神经前后径和横截面积均大于对照组,评分高者组的胫神经左右径、胫神经前后径和横截面积均大于评分低者组,胫神经左右径、前后径和横截面积与密歇根筛查量表评分均相关,胫神经横截面积与密歇根筛查量表评分的相关性最好。结论糖尿病患者胫神经超声改变特征与密歇根筛查量表评分关系密切,可作为糖尿病患者周围神经病变筛查的工具之一。

Objective To investigate the ultrasound characteristics of tibial nerve changes and the relation with Michigan screening scale score in patients with type Ⅱ diabetes mellitus. Methods Tibial nerve ultrasonography was performed in 139 patients with diabetes mellitus and 25 normal controls.According to Michigan screening scale,the enrolled patients were divided into the following groups： 1 score group,1 ~ 2 score group,2 ~ 3 score group,3 ~ 4 score group and 4 score group.The left-right diameter,anteroposterior diameter and cross sectional area of tibial nerve were measured.The differences in age,sex,changes of tibial nerve among different Michigan screening scale score groups were compared. The relationship between of tibial nerve changes and Michigan screening scale scores were analyzed.Results Except the 1 ~ 2 score and the 1 score groups,the differences in the left-right diameter,anteroposterior diameter and cross sectional area of tibial nerve were statistically significant among another three groups（ all P〈0. 05）.Furthermore,the left-right diameter,anteroposterior diameter and cross-sectional area of tibial nerve were larger in the patients than health controls.These changes in the groups with high Michigan screening scale score were larger than those in the groups with lower Michigan screening scale score.The left-right diameter,anteroposterior diameter and cross-sectional area of the tibial nerve were significantly correlated with the Michigan screening scale score,in which the correlation between the cross-sectional area of tibial nerve and the Michigan screening scale was the best.Conclusion The characteristics of tibial nerve ultrasound changes in diabetic patients are closely related to the Michigan screening scale score,which can be used as a screening tool for diabetic peripheral neuropathy.