神经电生理检测在慢性周围神经病病情评估中的作用

目的比较糖尿病性周围神经病和慢性肾衰竭性周围神经病的电生理特征与差异,为临床神经电生理检测提供可靠依据.方法选取2017年10月至2020年6月糖尿病性周围神经病患者57例和慢性肾衰竭性周围神经病患者47例,应用肌电诱发电位仪对每组患者进行神经传导检测(NCS),比较两组疾病的电生理表现与差异.结果糖尿病性周围神经病与慢性肾衰竭性周围神经病患者随着发病时间及病情进展,上下肢NCS异常率相应升高,且下肢异常率高于上肢异常率(P<0.01).慢性肾衰竭性周围神经病运动神经CMAP异常率(51.06%)、MCV异常率(68.09%)均高于糖尿病性周围神经病运动神经CMAP异常率(26.32%)、MCV异常率(43.86%)(P<0.01或P<0.05),感觉神经SCV异常率(65.96%)高于糖尿病性周围神经病感觉神经SCV异常率(40.35%)(P<0.05).结论糖尿病性周围神经病和慢性肾衰竭性周围神经病均有其独特的神经电生理表现,对这两类疾病行NCS有利于早期诊断.

Objective To investigate the electrophysiological characteristics and differences between diabetic peripheral neuropathy and chronic renal failure peripheral neuropathy,and to provide reliable basis for clinical neuroelectrophysiological testing.Methods 57 patients with diabetic peripheral neuropathy and 47 patients with chronic renal failure peripheral neuropathy who were diagnosed and treated in our hospital from October 2017 to June 2020 were selected.Nerves conduction Study(NCS)were performed in every patient by the myo-electric potential/evoked potential meter,to compare and analyze the electrophysiological manifestations and difierences between the two groups of disease.Results Diabetic peripheral neuropathy and chronic renal failure peripheral neuropathy patients along with progression disease,the upper and lower limb NCS abnormal rate increased accordingly.The abnormal rate of lower extremity was higher than that of upper limb(P<0.01).The abnormal rate of various indicators of chronic renal failure peripheral neuropathy was higher than that of patients with diabetic peripheral neuropathy.The abnonnal rates of compound muscle action potential(CMAP)and motor conduction velo city(MCV)were higher than those of the diabetic peripheral neuropathy(51.06% and 68.09%VS.26.32% and 43.86%),(P<0.01 or P<0.05).The abnormal rate of sensory nerve conduction velocity(SCV)was higher than that of diabetic peripheral neuropathy(65.96%VS.40.35%),(P<0.05).Conclusion Both diabetic peripheral neuropathy and chronic renal failure peripheral neuropathy have their unique neuroelectrophysiological manifestations.NCS for these two types of diseases is beneficial to early diagnosis.