Analysis of the characteristics of diabetic peripheral nerve damage by high frequency ultrasound combined with QTT

Objective: High frequency ultrasound combined with policy thermal perception testing (QTT) was used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy (DPN), and then provided the basis for the clinical prevention, diagnosis and treatment of DPN. Methods: A total of 110 DPN patients admitted to the hospital from December 2015 to May 2018 were selected, and the characteristics of nerve damage in diabetic peripheral neuropathy were analyzed by ultrasound and QTT. Results: In the results of QTT, the abnormal proportion of the CDT, WDT, CPT and HPT of the lower limbs in DPN's were all higher than the upper limbs;The difference of WDT and HPT in the age and course groups of patients in the upper limbs was statistically significant, the abnormal proportion of WDT and HPT in patients aged 60 years or above or with a course of 10 years or more were all above 45%, higher than those in other groups. The patients with larger mean amplitude of glycemic excursions (MAGE) were significantly higher than those with smaller MAGE, regardless of the abnormal proportion of WDT and HPT observed in upper limbs, lower limbs or upper and lower limbs;The results of ultrasonic measurement of nerve cross sectional area showed: the proportion of patients with ulnar nerve and median nerve abnormally thickened in the high age group (≥45 years) and the long course group (>10 years) was significantly higher than that in the low age group (<45 years) and the short course group (<10 years), the proportion of patients with larger MAGE with abnormal enlargement of median nerve was significantly higher than those with smaller MAGE. The thickening of ulnar nerve, median nerve and peroneal nerve was obvious in the patients of MAGE > 4 mmol/L. Conclusion: (1) The main nerve damage in DPN patients was thermal sensation damage, and the lower limb nerve was more vulnerable than the upper limb nerve. (2) The incidence of ulnar and median nerve damage was higher in patients aged 45 years and older or over 10 years of course. (3) Patients with large MAGE (> 4 mmo/L) had higher incidence of median nerve damage. The above characteristics of nerve damage can provide basis for clinical prevention, diagnosis and treatment of DPN.