摘要
背景:F波最短潜伏期和传导速度已广泛应用于各种神经病变的检测。然而,F波的其他参数的意义和诊断评估价值较少见报道,其对提高糖尿病周围神经病早期评估敏感性如何?目的:探讨F波各参数在糖尿病周围神经病的早期评估意义。设计:以2型糖尿病患者和健康人为研究对象的病例-对照研究。单位:武汉大学人民医院神经科和内分泌科病房和门诊。对象:糖尿病组为1999-01/2000-12武汉大学人民医院神经科和内分泌科就诊的2型糖尿病患者106例,男64例,女42例,平均(55±13)岁;糖尿病平均病程(10.2±4.8)年。正常对照组为75例健康志愿者,男45例,女30例,平均年龄(54±12)岁。两组间年龄、腿长匹配(P>0.05)。干预:以Nicolet-VikingIV肌电图仪,对糖尿病组和对照组胫神经进行F波测定;同时记录M波。主要观察指标:①2型糖尿病患者和正常人F波最短潜伏期(Fmin)、时限(Fdur)、波幅(Famp)和面积(Farea);M波负峰波幅(Mamp)和面积(Marea)的差异。②有无神经病变及不同病变程度2型糖尿病患者异常胫神经F波分布情况。结果:①对照组Fmin上限(Y)与腿长(X)的函数关系为Y=12.3+48.8X2。②无神经病变患者组(n=30)Fdur增宽8例(异常率27%)、Fmin延长4例(13%)、F/Marea增大2例。③与对照组比较,有神经病变患者组(n=76)Fmin延长。
BACKGROUND: The minimal latency and conduction velocity of F wave have been widely used for the detection of varied neurological disorders, whereas the significance and the diagnostic value for the other parameters of F wave are seldom reported.How sensitive are these parameters in the earlier evaluation of diabetic peripheral neuropathy(DPN)?OBJECTIVE:To investigate the evaluating value of F wave parameters for the earlier DPN,providing references for earlier clinical rehabilitative intervention. DESIGN:Case control study with type 2 diabetic patients and health people as subjects.SETTING:The wards and outpatients in the Departments of Neurology and Endocrinology,Renmin Hospital of Wuhan University.PARTICIPANTS:Between January 1999 and December 2000,there were totally 106 patients with type 2 diabetic mellitus(DM) at the wards and outpatients in the department of neurology and endocrinology in Renmin Hospital of Wuhan University, including 64 males and 42 females, with the average age of (55± 13) years and the average DM course of (10.2± 4.8) years.Meanwhile,75 healthy volunteers were enrolled in the control group, including 45 males and 30 females,with the mean age of(54± 12) years. Two groups were matched in age and leg length(P >0.05).INTERVENTIONS:Using Nicolet Viking IV, F wave and M wave parameters of tibial nerve stimulation were analyzed.MAIN OUTCOME MEASURES:The minimum latency (Fmin), duration (Fdur), amplitude(Famp) and area(Farea) of F wave; and the amplitude (Mamp) and aera(Marea) of M wave.RESULTS:① In the controls, the function of upper limit of the Fmin(Y) and leg length(X) was Y=12.3+ 48.8X2. ② In the DM patients without neuropathy(n=30), there were 8 cases(the abnormal rate being 27% ) with increased Fdur, 4(13% ) with prolonged Fmin and 2(7% ) with increased F/Marea.③ Compared with the patients without neuropathy,Fmin prolonged,F/Mamp and F/Marea increased significantly in the patients with DPN(n=76).④ Compared to the patients with severe DPN subgroup(n=29),the abnormality rate of Fdur was significantly higher (96% vs 21% , P< 0.01),the abnormality rate of Fmin was significantly lower(51% vs 76% , P< 0.05) and there were no significant difference of other parameters(P >0.05) in the patients with mild DPN subgroup(n=47).CONCLUSION: ① F wave(especially Fdur) could be used as a sensitive diagnostic parameter for earlier DPN, and therefore detect the sub clinical lesions. ② Both proximal and distal nerve segments could be affected in the DPN, and the proximal may be earlier involved than the distal.
出处
《中国临床康复》
CSCD
北大核心
2005年第17期202-204,共3页
Chinese Journal of Clinical Rehabilitation
