糖尿病周围神经病超声诊断评分
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摘要
目的探讨神经超声评分(DCEC评分)在糖尿病周围神经病诊断中的应用。方法 73例2型糖尿病患者分为亚临床糖尿病周围神经病组15例与糖尿病周围神经病组58例。对所有入组者进行DCEC评分,使用受试者工作特性(receiver operating characteristic,ROC)曲线定义DCEC评分的临界值,同时分析其敏感度、特异度、准确度、阳性似然比及阴性似然比。结果当DCEC评分≥14.5分时,其诊断的糖尿病周围神经病为50例,敏感度为81.0%,特异度为80.0%,准确度为80.8%,阳性似然比为4.05,阴性似然比为0.24。结论神经超声评分能有效诊断糖尿病周围神经病,可作为诊断糖尿病周围神经病的一种新方法应用于临床。
Objective To explore the application of nerve ultrasound score(DCEC score) in the diagnosis of diabetic peripheral neuropathy. Methods Seventy-three patients with type 2 diabetes were divided into subclinical diabetic peripheral neuropathy group(n=16) and diabetic peripheral neuropathy group(n=58). DCEC score was obtained from all participants. The cut-off value of DCEC score was defined by the receiver operating characteristic(ROC) curve,and its sensitivity, specificity, accuracy, positive likelihood ratio and negative likelihood ratio were analyzed. Results When the DCEC score was ≥14.5, 50 cases of diabetic peripheral neuropathy were diagnosed. The sensitivity was 81.0%, the specificity was 80.0%, the accuracy was 80.8%, the positive likelihood ratio was 4.05, and the negative likelihood ratio was 0.24. Conclusion DCEC score can effectively diagnose diabetic peripheral neuropathy which can be used as a new method to diagnose diabetic peripheral neuropathy.
Objective To explore the application of nerve ultrasound score(DCEC score) in the diagnosis of diabetic peripheral neuropathy. Methods Seventy-three patients with type 2 diabetes were divided into subclinical diabetic peripheral neuropathy group(n=16) and diabetic peripheral neuropathy group(n=58). DCEC score was obtained from all participants. The cut-off value of DCEC score was defined by the receiver operating characteristic(ROC) curve,and its sensitivity, specificity, accuracy, positive likelihood ratio and negative likelihood ratio were analyzed. Results When the DCEC score was ≥14.5, 50 cases of diabetic peripheral neuropathy were diagnosed. The sensitivity was 81.0%, the specificity was 80.0%, the accuracy was 80.8%, the positive likelihood ratio was 4.05, and the negative likelihood ratio was 0.24. Conclusion DCEC score can effectively diagnose diabetic peripheral neuropathy which can be used as a new method to diagnose diabetic peripheral neuropathy.
引文
[1]IQBAL Z,AZMI S,YADAV R,et al.Diabetic peripheral neuropathy:epidemiology,diagnosis,and pharmacotherapy[J].Clinical Therapeutics,2018,40(6):1-22.
[2]吴香花.神经病理性疼痛的临床及声像学特点[D].贵州医科大学,2018.
[3]AMERICAN DIABETES ASSOCIATION.Standards of Medical Care in Diabetes-2010[J].Diabetes Care,2013,33(S1):S11-S61.
[4]TESFAYE S,BOULTON AJ,DYCK PJ,et al.Diabetic neuropathies:update on definitions,diagnostic criteria,estimation of severity,and treatments[J].Diabetes Care,2010,33(10):2285-2293.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):893-942.
[6]CHEN J,WU S,REN J.Ultrasonographic reference values for assessing normal radial nerve ultrasonography in the normal population[J].Neural Reqen Res,2014,9(20):1844-1849.
[7]陈军,吴珊.高频超声对上肢尺神经正常值的研究[J].实用医学杂志,2012,28(6):908-910.
[8]CHEN J,WU S,REN J.Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang,China[J].Neural Regeneration Research,2011,6(24):1883-1887.
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[10]牛莉,靳娇婷,胡芳,等.2型糖尿病患者的无症状周围神经病神经电生理损害相关因素分析[J].中国临床神经科学,2015,23(3):310-315.
[11]PELTIER A,GOUTMAN SA,CALLAGHAN BC.Painful diabetic neuropathy[M].Clinical Management of Diabetic Neuropathy By Humana Press,2014:133-146.
[12]魏薇,董敬坚,汪娥,等.神经量表对糖尿病周围神经病变的诊断价值评估[J].临床内科杂志,2017,34(2):96-99.
[13]KERASNOUDIS A,PITAROKOILI K,BEHRENDT V,et al.Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy[J].Clin Neurophysiol,2014,125(3):635-641.
[14]GRIMM A,DECARS BF,AXER H,et al.The Ultrasound pattern sum score-UPSS.A new method to differentiate acute and subacute neuropathies using ultrasound of the peripheral nerves[J].Clin Neurophysiol,2015,126(11):2216-2225.
[15]曾娇,何珊,吴珊.2型糖尿病下肢周围神经超声表现与多伦多临床评分的关系[J].实用医学杂志,2016,32(12):1945-1948.
[16]孙冬梅,王艳滨.2型糖尿病伴周围神经病变胫神经的超声特征[J].中国医学影像学杂志,2014,22(10):781-783.
[2]吴香花.神经病理性疼痛的临床及声像学特点[D].贵州医科大学,2018.
[3]AMERICAN DIABETES ASSOCIATION.Standards of Medical Care in Diabetes-2010[J].Diabetes Care,2013,33(S1):S11-S61.
[4]TESFAYE S,BOULTON AJ,DYCK PJ,et al.Diabetic neuropathies:update on definitions,diagnostic criteria,estimation of severity,and treatments[J].Diabetes Care,2010,33(10):2285-2293.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):893-942.
[6]CHEN J,WU S,REN J.Ultrasonographic reference values for assessing normal radial nerve ultrasonography in the normal population[J].Neural Reqen Res,2014,9(20):1844-1849.
[7]陈军,吴珊.高频超声对上肢尺神经正常值的研究[J].实用医学杂志,2012,28(6):908-910.
[8]CHEN J,WU S,REN J.Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang,China[J].Neural Regeneration Research,2011,6(24):1883-1887.
[9]CHEN J,LIU JP,ZENG J,et al.Ultrasonographic reference values for assessing normal sciatic nerve ultrasonography in the normal population[J].Journal of Medical Ultrasound,2018,6(13):85-89.
[10]牛莉,靳娇婷,胡芳,等.2型糖尿病患者的无症状周围神经病神经电生理损害相关因素分析[J].中国临床神经科学,2015,23(3):310-315.
[11]PELTIER A,GOUTMAN SA,CALLAGHAN BC.Painful diabetic neuropathy[M].Clinical Management of Diabetic Neuropathy By Humana Press,2014:133-146.
[12]魏薇,董敬坚,汪娥,等.神经量表对糖尿病周围神经病变的诊断价值评估[J].临床内科杂志,2017,34(2):96-99.
[13]KERASNOUDIS A,PITAROKOILI K,BEHRENDT V,et al.Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy[J].Clin Neurophysiol,2014,125(3):635-641.
[14]GRIMM A,DECARS BF,AXER H,et al.The Ultrasound pattern sum score-UPSS.A new method to differentiate acute and subacute neuropathies using ultrasound of the peripheral nerves[J].Clin Neurophysiol,2015,126(11):2216-2225.
[15]曾娇,何珊,吴珊.2型糖尿病下肢周围神经超声表现与多伦多临床评分的关系[J].实用医学杂志,2016,32(12):1945-1948.
[16]孙冬梅,王艳滨.2型糖尿病伴周围神经病变胫神经的超声特征[J].中国医学影像学杂志,2014,22(10):781-783.