血清尿酸水平结合神经肌电图在糖尿病周围神经病变早期诊断中的应用价值

Application Value of Serum Uric Acid Level Combined with Nerve Electromyogram in the Early Diagnosis of Diabetic Peripheral Neuropathy

目的:探究血清尿酸水平结合神经肌电图在糖尿病周围神经病变(DPN)早期诊断中的应用价值。方法:选择2019年6月-2021年6月南方医科大学南方医院收治的113例糖尿病患者,其中48例不合并DPN(NDPN组),65例合并DPN(DPN组)。所有患者均检测临床生化指标、血清尿酸水平,并进行神经肌电图检查,比较各组检测结果差异,评价血清尿酸水平结合神经肌电图诊断DPN的效能。结果:DPN组病程显著长于NDPN组(P<0.05),两组性别分布、年龄、体重指数、空腹血糖及糖化血红蛋白的资料比较,差异均无统计学意义(P>0.05);DPN组患者尿酸水平高于NDPN组(P<0.05),正中神经、尺神经、腓总神经的运动神经传导速度,以及正中神经、尺神经、腓浅神经的感觉神经传导速度水平均低于NDPN组(P<0.05),神经肌电图异常率高于NDPN组(P<0.05)。血清尿酸诊断DPN的敏感度和特异度分别为70.77%和85.42%,各项神经传导速度诊断DPN的ROC曲线下面积均>0.750,但单一项诊断敏感度或特异度偏低,血清尿酸+神经肌电图诊断的敏感度和特异度分别为95.38%和97.92%。结论:血清尿酸水平结合神经肌电图在DPN诊断中具有较高效能,可用于疾病早期诊疗。

Objective:To explore the application value of combination of serum uric acid level and nerve electromyogram in the early diagnosis of diabetic peripheral neuropathy(DPN).Method:A total of 113 patients with diabetes mellitus admitted to Nanfang Hospital,Southern Medical University were enrolled from June 2019 to June 2021,among which there were 48 cases without complicated with DPN(NDPN group)and 65 cases complicated with DPN(DPN group).The clinical biochemical indicators and serum uric acid were detected among all patients,and nerve electromyography was performed.The differences in detection results were compared between the groups,and the efficiency of serum uric acid level combined with nerve electromyogram in the diagnosis of DPN was evaluated.Result:The course of disease in DPN group was significantly longer than that in NDPN group(P<0.05),but there were no statistical differences in the data such as gender distribution,age,body mass index,fasting blood glucose and glycosylated hemoglobin between the two groups(P>0.05).The uric acid level of DPN group was higher than that of NDPN group(P<0.05),while the motor nerve conduction velocities of median nerve,common peroneal nerve,ulnar nerve and sensory nerve conduction velocities of median nerve,superficial peroneal nerve and ulnar nerve were lower compared with those of NDPN group(P<0.05),and the abnormal rate of nerve electromyogram was higher than that of NDPN group(P<0.05).The sensitivity and specificity of serum uric acid in diagnosing DPN were 70.77%and 85.42%respectively.The areas under the ROC curves of various nerve conduction velocities in diagnosing DPN were>0.750,but the sensitivity or specificity of single diagnosis were low.The sensitivity and specificity of serum uric acid+nerve electromyogram were 95.38%and 97.92%respectively.Conclusion:The combination of serum uric acid level and nerve electromyogram has a high efficiency in the diagnosis of DPN and can be used for early diagnosis and treatment of the disease.