F波离散度在检测无症状糖尿病周围神经病变方面的应用价值

F wave dispersion in detection of asymptomatic diabetic peripheral neuropathy

目的回顾性分析F波离散度(Fchd)在检测无症状糖尿病周围神经病变(ADPN)方面的应用价值。方法选取南京中医药大学连云港附属医院2017年3月至2020年1月糖尿病科诊治的无明显周围神经损害症状的2型糖尿病(T2DM)患者79例,均进行神经传导速度(NCV)检测,依据检测结果分为NCV正常组与NCV异常组,分别进行上肢尺神经、下肢胫神经的F波检测,对两组F波各参数进行比较分析。结果NCV正常组45例,其中男性31例,女性14例,年龄(50.04±12.38)岁,病程(20.84±19.33)个月;NCV异常组34例,其中男性27例,女性7例,年龄(57.68±13.09)岁,病程(30.94±19.39)个月;NCV异常组患者的年龄高于NCV正常组、病程长于NCV正常组,差异均有统计学意义(均P<0.05)。NCV异常组F波异常率为100.00%(34/34),NCV正常组F波异常率为51.11%(23/45),NCV异常组F波异常率高于NCV正常组F波异常率,差异有统计学意义(P<0.05);胫神经总异常率为69.62%(55/79),高于尺神经总异常率31.64%(25/79),差异有统计学意义(P<0.05);尺神经、胫神经中Fchd总异常率为47.46%(75/158),高于F波平均潜伏期(Flmean)总异常率20.88%(33/158)、F波出现率总异常率12.65%(20/158),差异均有统计学意义(均P<0.05)。结论F波是早期检测ADPN的重要电生理方法,其中胫神经Fchd是F波检测的敏感指标。

Objective To retrospectively analyze the application value of F wave dispersion(Fchd)in the detection of asymptomatic diabetic peripheral neuropathy(ADPN).Methods From March 2017 to January 2020,79 patients with type 2 diabetes mellitus(T2DM)without obvious symptoms of peripheral nerve damage were collected.All the patients were tested for nerve conduction velocity(NCV).According to the test results,they were divided into an NCV abnormal group and an NCV normal group.The F waves of ulnar and tibial nerves of their upper limbs were detected respectively.The F wave parameters of the two groups were compared and analyzed.Results There were 45 patients in the NCV normal group,who were(50.04±12.38)years old and whose disease course was(20.84±19.33)months,including 31 males and 14 females;there were 34 patients in the NCV abnormal group,who were(57.68±13.09)years old and whose disease course was(30.94±19.39)months,including 27 males and 7 females;there were statistical differences in the age and disease course between these two groups(both P<0.05).The abnormal rate of F wave was 100.00%(34/34)in the NCV abnormal group,and was 51.11%(23/45)in the NCV normal group(P<0.05).The total abnormal rate of the tibial nerves was 69.62%(55/79),and that of the ulnar nerves was 31.64%(25/79)(P<0.05).The total abnormal rate of Fchd in the ulnar and tibial nerves was 47.46%(75/158),which was higher than the average incubation period of the F wave(Flmean)[20.88%(33/158)]and the total abnormal rate of F wave appearance[12.65%(20/158)](P<0.05).Conclusion F-wave is an important electrophysiological method for the early detection of ADPN,and tibial nerve Fchd is a sensitive indicator for F-wave detection.