中国东部某三甲医院老年糖尿病周围神经病变患者的神经传导速度特点分析

Analysis of characteristics of nerve conduction velocity in elderly patients with diabetes peripheral neuropathy in a Grade Ⅲ and Class A hospital in eastern China

中文关键词: 老年人  糖尿病  糖尿病周围神经病变  神经传导速度

英文关键词: elderly  diabetes mellitus  diabetic peripheral neuropathy  nerve conduction velocity

中文摘要:

      目的 分析老年糖尿病周围神经病变(DPN)患者的神经传导速度特点,并探讨其应用价值.方法 回顾性分析2022 年3 月—2023 年6 月于复旦大学附属华东医院内分泌科就诊的338 例老年糖尿病患者临床资料.根据神经电生理检查结果是否异常,将受试者分为研究组(n =220)和对照组(n =118).比较2 组正中神经、尺神经和腓总神经的运动神经传导速度(MNCV)、远端运动潜伏期(DML)、近端运动潜伏期(PML)、远端波幅和近端波幅;正中神经、尺神经和腓浅神经的感觉神经传导速度(SNCV)、潜伏期和波幅;尺神经的F波潜伏期.分析研究组运动神经传导异常率和远端波幅异常率;感觉神经传导异常率和波幅异常率.结果 与对照组相比,研究组正中神经MNCV较慢,DML、PML较长,远端波幅较小,差异均有统计学意义(P＜0.05);研究组尺神经和腓总神经MNCV较慢,DML、PML较长,远端波幅、近端波幅较小,差异均有统计学意义(P＜0.05).与对照组相比,研究组正中神经、尺神经和腓浅神经潜伏期较长,波幅较小,SNCV较慢,差异有统计学意义(P＜0.05).与对照组相比,研究组尺神经F波潜伏期较长[(26.02±2.02)ms vs(27.75±2.78)ms,P＜0.001],差异有统计学意义.研究组不同运动神经传导异常率和不同感觉神经传导异常率差异有统计学意义;不同运动神经传导远端波幅异常率和不同感觉神经传导波幅异常率差异有统计学意义(P＜0.05).结论 老年DPN患者神经传导速度较慢,潜伏期较长,波幅较小.神经传导速度检测结果因选择的神经不同可能有所差异.

英文摘要:

      Objective To analyze the characteristics of nerve conduction velocity in elderly patients with diabetic pe-ripheral neuropathy(DPN),and discuss its application value.Methods The clinical data of 338 elderly patients with diabetes who visited the Department of Endocrinology of Huadong Hospital Affiliated to Fudan University from March 2022 to June 2023 were analyzed retrospectively.They were divided into research group(n =220)and control group(n =118)based on whether the results of their neurophysiological examination were abnormal.The motor nerve conduction velocity(MNCV),distal mo-tor latency(DML),proximal motor latency(PML),distal wave amplitude and proximal wave amplitude of median nerve,ul-nar nerve and common peroneal nerve were compared between the two groups.The sensory nerve conduction velocity(SNCV),latency and amplitude of median nerve,ulnar nerve and superficial peroneal nerve were compared between the two groups.The F-wave latency of ulnar nerves was also compared between the two groups.The abnormal rates of motor nerve conduction and distal wave amplitude in the research group were analyzed,and the abnormal rate of sensory nerve conduction and wave amplitude were analyzed.Results Compared with the control group,the MNCV of the median nerve of the research group was slower,DML and PML were longer,and the distal wave amplitude was smaller,and the differences were statistical-ly significant(P＜0.05);the MNCV of the ulnar nerve and common peroneal nerve of the research group was slower,DML and PML were longer,and distal and proximal wave amplitudes were smaller,and the differences were statistically significant(P＜0.05).Compared with the control group,the research group had a longer F-wave latency of the ulnar nerve[(26.02±2.02)ms vs(27.75±2.78)ms,P =0.167],and the difference was statistically significant.There were statistically significant differences in the abnormal rates of motor nerve conduction and sensory nerve conduction among different nerves in the research group;the abnormal rate of distal motor nerve conduction amplitude and sensory nerve conduction amplitude.Conclusion Elderly DPN patients have slower nerve conduction velocity,longer latency,and smaller wave amplitude.The re-sults of nerve conduction velocity detection may vary depending on the nerve selected.