老年糖尿病周围神经病变患者平衡与神经传导速度的相关性研究

Correlation between balance function and nerve conduction velocity in elderly patients with diabetic peripheral neuropathy

目的探讨老年糖尿病周围神经病变(DPN)患者平衡功能与神经传导速度(NCV)的相关性。方法选取老年糖尿病患者81例,根据其是否为糖尿病周围神经病变患者分为2组:DPN组(n=39)和非DPN组(n=42)。分别对2组进行功能性伸展测试(FRT)和计时站立走测试(TUG),同时测定2组左右下肢腓总神经、胫神经、腓肠神经和腓浅神经神经传导速度。2组FRT和TUG分别和NCV进行相关性分析,同时就FRT和TUG与NCV、BMI、腰臀比和年龄进行多元线性回归分析。结果DPN组FRT与右腓肠感觉神经传导速度的相关系数为0.328(P<0.05),呈正弱相关;TUG与双下肢腓总运动神经传导速度的相关系数分别是-0.535(P<0.05)和-0.331(P<0.05),呈弱负相关;与左胫后运动神经传导速度相关系数为-0.342(P<0.05),呈弱负相关;与左腓浅感觉神经传导速度的相关系数为-0.480(P<0.05),呈中等负相关。非DPN组FRT和TUG都与下肢四条神经的NCV无显著相关性(P>0.05)。多元线性回归分析显示,在非DPN组中,FRT和TUG与NCV、BMI、腰臀比以及年龄这4个危险因素没有相关性(P>0.05);在DPN组中,TUG与NCV和BMI有较大的相关性,R2分别为0.567和0.211(P<0.05)结论老年DPN患者下肢整体的神经传导速度与平衡相关,表明下肢周围神经的损害可能是造成老年DPN患者平衡功能障碍的原因之一。

Objective To investigate the relationship between the balance function and nerve conduction velocity(NCV in elderly patients with diabetic peripheral neuropathy(DPN).Methods From March 2019 to August 2019,81 elderly diabetic patients were divided into two groups:DPN group(n=39)and non DPN group(n=42).Functional extension test(FRT)and timed standing walking test(TUG)were carried out,and the conduction velocities of the common peroneal nerve,tibial nerve,gastrocnemial nerve and superficial peroneal nerve were measured in all patients.The correlation between FRT and TUG and NCV was analyzed respectively,and multiple linear regression analysis was carried out among FRT and TUG and NCV,BMI,waist hip ratio and age in both groups.Results The correlation coefficient between FRT and right sural sensory nerve conduction velocity in DPN group was 0.328(P<0.05),showing a positive and weak correlation.The correlation coefficient between TUG and conduction velocity of peroneal motor nerves in lower extremities was-0.535(P<0.05)and-0.331(P<0.05),showing a medium negative correlation.The correlation coefficient with the conduction velocity of left tibial posterior motor nerve was-0.342(P<0.05),showing a weak negative correlation.The correlation coefficient with the conduction velocity of left superficial peroneal sensory nerve was-0.480(P<0.05),showing a medium negative correlation.Both FRT and TUG in the non-DPN group were not correlated with NCV of the four nerves of the lower limbs(P>0.05).Multiple linear regression analysis showed that FRT and TUG were not correlated with NCV,BMI,waist hip ratio and age.In DPN group,TUG was significantly correlated with NCV and BMI,R2 was 0.567 and 0.211,respectively(P<0.05).Conclusions The nerve conduction velocity of the whole lower extremity in DPN patients is related to the balance,which indicated that the damage of the peripheral nerve of the lower extremity might be one of the causes of the balance dysfunction in the elderly DPN patients.