| 马桂娟,王 丽,张 灿,马新安,吴培培.肌电图多参数检测对2型糖尿病患者无症状性周围神经病变的诊断价值分析[J].,2023,(15):2960-2963 |
| 肌电图多参数检测对2型糖尿病患者无症状性周围神经病变的诊断价值分析 |
| Diagnostic Value of Multi-parameter Detection of Electromyography in Asymptomatic Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus |
| 投稿时间：2023-02-07 修订日期：2023-02-28 |
| DOI：10.13241/j.cnki.pmb.2023.15.031 |
| 中文关键词: 糖尿病周围神经病变 神经肌电图 F波 H反射 诊断 |
| 英文关键词: Diabetic peripheral neuropathy Neuroelectromyogram F wave H reflection Diagnosis |
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| 摘要 目的：探讨肌电图对无症状糖尿病周围神经病变（DPN）的诊断价值。方法：选取2020年1月~2022年12月就诊于本院的2型糖尿病（T2DM）患者142例，根据是否伴随DPN将患者分为DPN组（n=68）与单纯T2DM组（n=74）。患者均进行神经肌电图检测，包括神经传导（NCS）、F波、H反射的检测；比较两组各项肌电图参数和NCS、F波、H反射异常率，并应用受试者工作特征（ROC）曲线评价NCS异常、F波异常、H反射异常及其联合对DPN的诊断效能。结果：相比单纯T2DM组，DPN组正中神经、尺神经等神经的远端运动潜伏期（DML）显著延长（P＜0.05），复合肌肉动作电位显著降低（P＜0.05）；同时DPN组感觉传导参数感觉传导速度（SNCV）、感觉神经动作电位（SNAP）低于单纯T2DM组（P＜0.05）。相比单纯T2DM组，DPN组尺神经和胫后神经的平均潜伏期（Fmean）和F波离散度（Fchd）均显著延长（P＜0.05）。DPN组胫后神经的最短潜伏期（Hmin）相比单纯T2DM组显著延长（P＜0.05）。DPN组NCS异常率、F波异常率以及H反射异常率均显著高于单纯T2DM组（P＜0.05）。 ROC曲线分析显示，NCS、F波、H反射诊断DPN的曲线下面积分别为0.659、0.614、0.671，三者联合的AUC为0.753，相比各单一指标均显著提高（P＜0.05）。结论：肌电图对于无症状DPN有着重要诊断作用，NCS、F波、H反射三项联合检测有助于提高DPN的早期诊断效能。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic value of electromyography in asymptomatic diabetic peripheral neuropathy (DPN). Methods: 142 patients with type 2 diabetes mellitus (T2DM) who were treated in our hospital from January 2020 to December 2022 were selected. According to whether they were accompanied by DPN, the patients were divided into DPN group (n=68) and simple T2DM group (n=74). All patients underwent nerve muscle point map detection, including nerve conduction (NCS), F wave and H reflex detection. The EMG parameters and abnormal rates of NCS, F wave and H reflex were compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of NCS abnormality, F wave abnormality, H reflex abnormality and their combination for DPN. Results: Compared with T2DM group, the distal motor latency (DML) of median nerve and ulnar nerve in DPN group was significantly increased (P＜0.05), and the compound muscle action potential was significantly decreased(P < 0.05). At the same time, the sensory conduction parameters of sensory conduction velocity (SNCV) and sensory nerve action potential (SNAP) in DPN group were lower than those in simple T2DM group (P＜0.05). Compared with T2 DM group, the mean latency (Fmean) and F wave dispersion (Fchd) of ulnar nerve and posterior tibial nerve in DPN group were significantly prolonged (P＜ 0.05). The shortest latency (Hmin) of posterior tibial nerve in DPN group was significantly longer than that in T2DM group (P＜ 0.05). The abnormal rates of NCS, F wave and H reflex in DPN group were significantly higher than those in T2 DM group (P＜ 0.05). ROC curve analysis showed that the areas under the curve of NCS, F wave and H reflex in the diagnosis of DPN were 0.659, 0.614 and 0.671, respectively. The AUC of the combination of the three was 0.753, which was significantly higher than that of each single index (P＜ 0.05). Conclusion: Electromyography plays an important role in the diagnosis of asymptomatic DPN. The combined detection of NCS, F wave and H reflex is helpful to improve the early diagnosis of DPN. |
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