F波最小潜伏期对糖尿病周围神经病的早期诊断价值

Early Diagnosis Value of F-wave Minimum Latency for Diabetic Peripheral Neuropathy

目的利用身高矫正的F波最小潜伏期探讨F波对于糖尿病周围神经病(DPN)的早期诊断价值。方法选取2018年1月至10月入院的2型糖尿病患者211例,进行下肢神经传导检查(NCS)和胫神经F波最小潜伏期测定。利用国人身高矫正后的F波参考值判定F波的异常。根据有无DPN临床症状和体征分为有症状组(n=126)和无症状组(n=85);根据糖尿病病程长短分为病程≤1年组(n=45)、病程>1~10年组(n=85)和病程>10年组(n=81)。比较各组下肢运动神经传导检查(MNCS)异常率、感觉神经传导检查(SNCS)异常率、总NCS异常率及F波最小潜伏期异常率。结果有症状组F波最小潜伏期异常率高于MNCS、SNCS和NCS异常率(χ2>7.088,P<0.01)。无症状组F波最小潜伏期异常率明显高于MNCS、SNCS和NCS异常率(χ2>7.545,P<0.01)。不同病程组的F波异常率大多数均大于MNCS、SNCS和NCS异常率(P<0.05)。结论糖尿病患者F波最小潜伏期的敏感性高于MNCS、SNCS和NCS,能够提示亚临床病变,对DPN的早期诊断具有重要意义。

Objective To study the early diagnostic value of F-wave for diabetic peripheral neuropathy (DPN). Methods A total of 211 patients with type 2 diabetes who were admitted to hospital from January to October, 2018 were selected. The nerve conduction studies (NCS) of lower limbs and the minimum latency of F-wave in tibial nerve were measured. The height corrected reference of F-wave was used to judge the abnormality of F-wave. According to the clinical symptoms and signs, they were divided into symptomatic group (n = 126) and asymptomatic group (n = 85). According to the duration of diabetes, they were divided into three groups: less than one year group (n = 45), one to ten years group (n = 85) and more than ten years group (n = 81). The abnormal rates of motor nerve conduction studies (MNCS), sensory nerve conduction studies (SNCS), NCS and F-wave minimum latency in different groups were compared. Results The abnormal rate of F-wave was higher than that of MNCS, SNCS and NCS in lower limbs in the symptomatic group (χ2 > 7.088, P < 0.01). The abnormal rate of F-wave in the asymptomatic group was prominently higher than that of MNCS, SNCS and NCS (χ2 > 7.545, P < 0.01). The abnormal rate of F-wave in each course was higher than that of MNCS, SNCS and NCS (P < 0.05). Conclusion The abnormal of F-wave minimum latency is more senstive than that of MNCS, SNCS and NCS, which suggested subclinical lesions, and is valuable for the early diagnosis of DPN.