神经肌电图对糖尿病病情评估的价值分析

Analysis of the value of neuroelectromyography in the assessment of diabetes

目的探讨在糖尿病患者生活质量及跌倒风险等病情评估方面神经肌电图的临床应用价值。方法回顾性分析2021年1月至2022年12月我院慢病管理中心糖尿病患者3150例,筛选完善肌电图及糖化血红蛋白、跌倒风险等评估的患者651例。分析H反射对糖尿病患者病程、BI指数、跌倒风险及神经损伤等方面的评估价值。结果H反射异常患者病程更长、跌倒风险更高、BI指数更低(P<0.05)。感觉神经肌电图比较,H反射异常组SNAP降低、SNCV减慢(P<0.05)。胫神经运动神经比较,H反射异常组双侧CMAP降低、MNCV减慢、DML延长(P<0.05)。腓总神经运动神经比较,H反射异常组双侧MNCV降低,左侧CMAP降低(P<0.05);右侧CMAP及双侧DML差异无统计学意义(P>0.05)。结论H反射有望成为糖尿病患者识别神经损伤、跌倒风险、生活能力下降的临床预警指标,有进一步研究的价值。

Objective To explore the clinical application value of electromyography(EMG)in the assessment of quality of life and risk of falling in patients with diabetes.Methods A total of 3,150 patients with diabetes in the chronic disease management center of our hospital from January 2021 to December 2022 were retrospectively analyzed.From these patients,651 patients with complete data such as electromyography,glycated hemoglobin and falling risk assessment were selected.The value of H-reflex in the assessment of disease duration,body mass index,quality of life score(BI),fall risk and nerve injury in the diabetic patients were analyzed.Results The diabetic patients with abnormal H-reflex had longer disease duration,higher falling risk,and lower BI index(P<0.05).In the comparison of the EMG of sensory nerves,sensory nerve action potential(SNAP)of the group with abnormal H-reflex was reduced and sensory nerve conduction velocity(SNCV)was slowed down(P<0.05).In the comparison of the tibial motor nerves,compound action potential(CMAP)was decreased in the H-reflex abnormality group,motor nerve conduction velocity(MNCV)was slowed down and distal motor latency(DML)was prolonged(P<0.05).In the comparison of the motor nerves of the common peroneal nerves,the H-reflex abnormality group had lower MNCV bilaterally and lower CMAP on the left side(P<0.05).The difference between CMAP on the right side and DML bilaterally was not statistically significant(P>0.05).Conclusions H-reflex has the potential to be a clinical early warning indicator for early recognition of nerve damage,falling risk,and decreased ability to perform daily life in diabetic patients.There is a value for further study.