糖尿病患者周围神经传导速度临床研究——附205例报告

Clinical study on peripheral nerve conduction velocity in 205 diabetic patients.

目的:探讨糖尿病患者的周围神经传导速度异常的发生率及其影响因素。方法:对经肌电图检测周围神经传导速度的205例糖尿病患者的临床资料进行回顾性分析,分析周围神经病变的发生率及与病程的关系,并将周围神经传导速度与患者的年龄、血压及空腹血糖、血脂、糖化血红蛋白水平,是否合并冠状动脉粥样硬化性心脏病等作多因素Logistic回归分析。结果:神经传导速度异常者138例(检出率67%),病程超过10年者与不足10年者的检出率分别为76%、60%,差异有统计学意义(P<0.05)。感觉神经病变的发生率(41%)明显高于运动神经病变(28%),下肢周围神经病变的发生率(49%)明显高于上肢周围神经病变(33%),差异均有统计学意义(P<0.01)。糖化血红蛋白和收缩压水平是周围神经病变的危险因素。结论:病程较长的糖尿病患者周围神经病变的发生率较高,高血糖状态和收缩压升高是糖尿病周围神经病变的危险因素。

Objective: To evaluate the changes of peripheral nerve co nduction velocity (NCV) and analyze the influence factors in diabetic patients. Methods: 205 diabetic patients who had measured sensory and motor nerve conduct ion velocity with electromyogram were reviewed retrospectively. Logistic regress ion was used for multivariate analysis of age, course of diseases, blood pressur e, fasting blood glucose levels, blood lipid levels, glycosylated hemoglobin an d NCV. Results: The electromyographic examination showed that 138 cases (67% ) had pathological changes in NCV. Among those diabetic patients with duration of the disease over 10 years, 76% had pathological changes in NCV. Among those d iabetic patients with duration of disease less than 10 years, 60% had patholog ical changes in NCV. Significant difference was found between the two groups. Th e incidence of sensory neuropathy was apparently higher than that of motor neuro pathy(41% vs 28% , P<0.01). The incidence of peripheral neuropathy of lower limbs was higher than that of upper limbs(49% vs 33% , P<0.01). Multiple fac tors regression analysis showed that HbA1c and systolic pressure were the risk f actors for decreased NCV (P<0.01 and P<0.05). Conclusion: There is a higher inc idence of peripheral neuropathy among those diabetic patients with longer course of the disease. High blood glucose level and systolic pressure are the major ri sk factors for diabetic peripheral neuropathy.