F波各参数对糖尿病周围神经病的诊断敏感性
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摘要
目的探讨F波各参数中对诊断糖尿病周围神经病(diabetic peripheral neuropathy,DPN)的敏感指标。方法随机选取81例2型糖尿病患者,检测其正中神经、尺神经、胫神经神经的传导速度(nerve conduction velocity,NCV)、F波。根据NCV结果分为NCV正常组和NCV异常组,比较两组同名神经各参数指标,比较NCV异常组各神经的F波与MCV异常率。结果糖尿病患者各神经F波最长潜伏期总异常率高于最短潜伏期、平均潜伏期、F波出现率、F波最大传导速度的总异常率,差异有统计学意义(P <0. 05)。与NCV正常组比较,NCV异常组正中神经F波的最短潜伏期、最长潜伏期、平均潜伏期、最大速度差异有统计学意义(P <0. 05),两组其他同名神经参数比较均无统计学差异。NCV异常组胫神经、正中神经、尺神经F波异常率明显高于同一神经的运动神经传导速度(motor nerve conduction velocity,MCV)异常率,差异有统计学意义(P <0. 05)。结论 F波最长潜伏期对DPN的诊断较敏感,NCV联合F波可以提高DPN的检出率。
Objective To investigate the most sensitive parameters of F wave in the diagnosis of diabetic peripheral neuropathy by using the F wave reference value of height correction. Methods Eighty-one cases of patients with type 2 diabetes were randomly selected,whose nerve conduction velocity( NCV) of the median nerve,ulnar nerve,tibial nerve and F wave were tested. According to the results of NCV tests,these patients were divided into the normal NCV group and the abnormal NCV group. The sensitivity of F wave parameters were analyzed by t-test and chi-square test. Results The total rate of abnormality of the longest latency of F wave of different nerves among patients of diabetes was higher than that of the shortest latency,the average latency,the occurrence rate of F wave and the F wave maximum conduction velocity( P < 0. 05). The difference was statistically significant. There was statistically significant difference between the two groups in terms of the shortest latency,the longest latency,the average latency,the maximum NCV( P <0. 05) of F wave of the median nerve. The rate of abnormality of F wave of the tibial nerve,the median nerve,and the ulnar nerve in the abnormal NCV group was significantly higher than that of motor nerve conduction velocity of the same nerve. Conclusions The longest latency of F wave is more sensitive to the diagnosis of DPN,so NCV combined with F wave can improve the detection rate of DPN.
Objective To investigate the most sensitive parameters of F wave in the diagnosis of diabetic peripheral neuropathy by using the F wave reference value of height correction. Methods Eighty-one cases of patients with type 2 diabetes were randomly selected,whose nerve conduction velocity( NCV) of the median nerve,ulnar nerve,tibial nerve and F wave were tested. According to the results of NCV tests,these patients were divided into the normal NCV group and the abnormal NCV group. The sensitivity of F wave parameters were analyzed by t-test and chi-square test. Results The total rate of abnormality of the longest latency of F wave of different nerves among patients of diabetes was higher than that of the shortest latency,the average latency,the occurrence rate of F wave and the F wave maximum conduction velocity( P < 0. 05). The difference was statistically significant. There was statistically significant difference between the two groups in terms of the shortest latency,the longest latency,the average latency,the maximum NCV( P <0. 05) of F wave of the median nerve. The rate of abnormality of F wave of the tibial nerve,the median nerve,and the ulnar nerve in the abnormal NCV group was significantly higher than that of motor nerve conduction velocity of the same nerve. Conclusions The longest latency of F wave is more sensitive to the diagnosis of DPN,so NCV combined with F wave can improve the detection rate of DPN.
引文
[1]闫淑静,刘宏雨.糖尿病神经电生理改变的研究[J].河北医药,2016,38(4):550-552.
[2]Yagihashi S,Yamagishi S,Wada R.Pathology and pathogenetic mechanisms of diabetic neuropathy correlation with clinical signs and symptoms[J].Diabetes Res Clin Pract,2007,77(1):184-189.
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[8]王贵平.糖尿病周围神经病的神经电生理及病理研究进展[J].临床神经电生理学杂志,2007,16(1):44-48.
[9]王彦,吴毓敏.探讨SEP、NCS、SSR、F波联合检测对糖尿病周围神经病变早期诊断的价值[J].中国实用神经疾病杂志,2017,20(9):58-61.
[10]Croog S H,Levi S,Testa M A,et al.The effect of anti hypertensive therapy on the quality of life[J].N Engl JMed,1986,14(3):1657-1659.
[11]Islam M R,Bhowmik N B,Haque A,et al.F wave latency-a frequent and early involved nerve conduction parameter in young diabetic subjects[J].Mymensingh Med J,2005,14(1):46-49.
[12]廖晓凌,张国华,高长玉,等.F波对糖尿病周围神经病诊断的意义[J].中国康复,2003,18(6):348-351.
[13]Andersen H,Stalborg E.F-wave latency,the most sensitive nerve conduction parameter in patients with diabetes mellitus[J].Muscle&Nerve,1997,10(20):1296-1302.
[14]Kocer A,Gozlee E.A comparison of f-wave in peripheral nerve disorders[J].Electromyography clin Neru,2005,78(45):417-423.
[15]Eccles J C.The central action of antidromic impulses in motor nerve fibers[J].Pflugers Arch,1955,260(5):385-415.
[16]Tauc L.Identification of active membrane areas in the giant neuron of Aplysia[J].Gen Physio J,1962,45(1):1099-1115.
[17]Chroni E.F tacheodispersion[J].Muscle nerve,1993,12(16):1302-1309.
[2]Yagihashi S,Yamagishi S,Wada R.Pathology and pathogenetic mechanisms of diabetic neuropathy correlation with clinical signs and symptoms[J].Diabetes Res Clin Pract,2007,77(1):184-189.
[3]Sima A A,Sugimoto K.Experimental diabetic neuropathy:an update[J].Diabetologia,1999,42(7):773-788.
[4]魏亚芬,刘永丹.F波在糖尿病亚临床神经病变诊断评估中的应用[J].糖尿病新世界,2016,19(3):61-63.
[5]潘华,林金嬉.国人F波正常参考值范围的建立[J].中华神经科杂志,2015,48(2):93.
[6]崔丽英.简明肌电图学手册[M].北京:科学出版社,2006:183-211.
[7]栾松,崔丽英.糖尿病性周围神经病发病机制和电生理研究进展[J].临床神经电生理学杂志,2005,14(1):44-47.
[8]王贵平.糖尿病周围神经病的神经电生理及病理研究进展[J].临床神经电生理学杂志,2007,16(1):44-48.
[9]王彦,吴毓敏.探讨SEP、NCS、SSR、F波联合检测对糖尿病周围神经病变早期诊断的价值[J].中国实用神经疾病杂志,2017,20(9):58-61.
[10]Croog S H,Levi S,Testa M A,et al.The effect of anti hypertensive therapy on the quality of life[J].N Engl JMed,1986,14(3):1657-1659.
[11]Islam M R,Bhowmik N B,Haque A,et al.F wave latency-a frequent and early involved nerve conduction parameter in young diabetic subjects[J].Mymensingh Med J,2005,14(1):46-49.
[12]廖晓凌,张国华,高长玉,等.F波对糖尿病周围神经病诊断的意义[J].中国康复,2003,18(6):348-351.
[13]Andersen H,Stalborg E.F-wave latency,the most sensitive nerve conduction parameter in patients with diabetes mellitus[J].Muscle&Nerve,1997,10(20):1296-1302.
[14]Kocer A,Gozlee E.A comparison of f-wave in peripheral nerve disorders[J].Electromyography clin Neru,2005,78(45):417-423.
[15]Eccles J C.The central action of antidromic impulses in motor nerve fibers[J].Pflugers Arch,1955,260(5):385-415.
[16]Tauc L.Identification of active membrane areas in the giant neuron of Aplysia[J].Gen Physio J,1962,45(1):1099-1115.
[17]Chroni E.F tacheodispersion[J].Muscle nerve,1993,12(16):1302-1309.