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电流感觉阈值在评估1型糖尿病患者早期周围神经受损中的价值 被引量:8

Evaluation of current perception threshold for early diagnosis in type 1 diabetes with diabetic peripheral neuropathy
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摘要 目的应用Neurometer* CPT/C神经测量仪检测临床确诊T1DM患者周围神经的电流感觉阈值(CPT),对比分析大小纤维受损的程度,从而为糖尿病周围神经病变(DPN)早期诊断提供有效证据。方法测定52例T1DM(T1DM)患者及40名正常对照(NC)者双侧正中神经、腓肠神经2000、250、5 Hz CPT,并检测两组HbA1 c、尿白蛋白/肌酐(UAlb/Cr)等代谢指标。结果与NC组比较,T1DM组双侧正中神经及腓肠神经2000、250、5 Hz频率下CPT降低(P〈0.05);T1DM组正中神经损伤数量与同侧腓肠神经损伤数量比较,异常率偏低(左侧x^2=16.99,P〈0.01;右侧x^2=10.34,P〈0.01);T1DM组CPT正常亚组与CPT异常亚组HbA1c水平比较,差异无统计学意义。二元Logistic回归分析显示,高HbA1c是发生DPN的独立危险因素。结论 CPT可以早期发现T1DM患者周围神经受损,同时DPN下肢神经较上肢神经易损,DPN患者HbA1c较高,且高HbA1c是DPN的独立危险因素。 Objective Current perception threshold(CPT) in patients with type 1 diabetes mellitus were tested by Neurometer CPT/C nerve measuring instrument to evaluate the injury severity of each fiber,thus to provide valid evidence for the early diagnosis of diabetic peripheral neuropathy(DPN).Methods 52 patient with T1DM(T1DM group) and 40 normal control group(NC group) were enrolled in this study.CPT value of bilateral median nerve and sural nerve at 2000 Hz,250 Hz,5 Hz were measured in all subjects.HbA1c urinary albumin creatinine ratio(UAlb/Cr) were tested.Results CPT values of bilateral median nerve and sural nerve at 2000 Hz,250 Hz,and 5 Hz frequency were significantly lower in TIDM group than in NC group(P〈0.01).The number of diabetic nerve damage was significantly lower in median nervethan insural nerve on one side(left side X = 16.99,P〈0.01;right side X =10.34,P〈0.01).The HbA1c level was similar between CPT normal and CPT abnormal patients in T1 DM group.Binary logistic regression analysis showed that high HbA1 c is an independent risk factor for DPN.Conclusion CPT can early detect peripheral neuropathy in patients with type 1 diabetes.The lower limb nerve in diabetic peripheral neuropathy is more vulnerable than upper limb nerve.HbA1 c level is higher in type 1 diabetes with DPN,and high HbA1c is an independent risk factor for DPN.
作者 方晨 吕圣龙 吴海英 陈林琪 郭鹤鸣 胡吉 FANG Chen , LO Sheng-long , WU Hai-ying , et al. (Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou 215000, China)
出处 《中国糖尿病杂志》 CAS CSCD 北大核心 2016年第4期339-343,共5页 Chinese Journal of Diabetes
基金 2015国家自然科学基金面上项目(81471041) 2014苏州市科技局应用基础研究计划(SYS201472)
关键词 糖尿病 1型 糖尿病周围神经病变 电流感觉阈值 Diabetes mellitus type 1 Diabetic peripheral neuropathy(DPN) Current perception threshold(CPT)
作者简介 通信作者:胡吉,E-mail:huji@suda.edu.cn
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参考文献20

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