HbA_(1)c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 HbA_(1)c combined with neural electromyography in the early diagnosis of diabetic peripheral neuropathy

目的研究糖化血红蛋白(HbA_(1)c)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2022年1月至2023年1月我院收治的45例糖尿病合并DPN患者作为DPN组,选择同期收治的68例非DPN糖尿病患者作为NDPN组。比较两组患者的HbA_(1)c及神经肌电图,分析HbA_(1)c结合神经肌电图在DPN早期诊断中的价值。结果DPN组患者的HbA_(1)c水平显著高于NDPN组,差异具有统计学意义(P<0.001)。DPN组正中神经、腓总神经和尺神经的运动传导速度(MCV)与正中神经、腓浅神经和尺神经的感觉传导速度(SCV)均明显低于NDPN组,差异均有统计学意义(均P<0.05)。HbA_(1)c诊断DPN的ROC曲线下面积(AUC)为0.85,当HbA_(1)c在8.12%时,敏感度与特异度分别为89%、68%。各神经传导速度诊断DPN的AUC均>0.75,但单一指标的敏感度或特异度较低。HbA_(1)c联合各神经传导速度诊断DPN的敏感度和特异度分别为98%和94%(P<0.05)。结论HbA_(1)c联合神经肌电图在DPN的早期诊断中有极高的准确性和可靠性。

Objective To investigate the application value of glycated hemoglobin A 1c(HbA_(1)c)combined with neural electromyography in the early diagnosis of diabetic peripheral neuropathy(DPN).Methods 45 diabetic patients with DPN admitted to our hospital from January 2022 to January 2023 were selected as the DPN group,while 68 diabetic patients without DPN admitted during the same period were selected as the non diabetic peripheral neuropathy(NDPN)group.HbA_(1)c and neuroelectromyography of two groups were compared,and the diagnostic value of HbA_(1)c combined with neuroelectromyography in diagnosing DPN was analyzed.Results The level of HbA_(1)c in DPN group was significantly higher than that in NDPN group,there was statistically significant difference(P<0.001).Motor conduction velocity(MCV)of median nerve,common peroneal nerve,ulnar nerve,and sensory nerve conduction velocity(SCV)of median nerve,superficial peroneal nerve,ulnar nerve in DPN group were lower than that in NDPN group,there were statistically significant difference(all P<0.05).The area under curve(AUC)of HbA_(1)c for DPN diagnosis was 0.85,and achieved a sensitivity rate of 89%and specificity rate of 68%when using a threshold set at 8.12%.The AUC of all nerve conduction velocities for DPN diagnosis were>0.75,however their sensitivity or specificity alone was relatively low.The sensitivity and specificity of HbA_(1)c combined with nerve conduction velocity in the diagnosis of DPN were 98%and 94%,respectively(P<0.05).Conclusion HbA_(1)c combined with neural electromyography has high accuracy and reliability in the early diagnosis of DPN..