摘要
目的:探讨接触性热痛诱发电位(CHEP)对糖尿病早期小纤维神经损害的评价作用,并分析糖尿病患者CHEP和神经传导特点。方法:选取糖尿病患者40例,根据有无大纤维神经损害分为2组,健康人40例作为对照组,分别行前臂、手背、小腿CHEP测定;并测定糖尿病组上下肢感觉和运动神经传导。结果:与对照组比较,无大纤维神经损害临床表现的糖尿病患者前臂、手背、小腿刺激Cz记录的N-P波波幅减低(P<0.05或P<0.01),小腿刺激N波潜伏期延长(P<0.05)。2组糖尿病患者CHEP下肢-上肢波幅比较对照组减低(P<0.05),神经传导显示下肢神经异常的比例高于上肢(P<0.05),同时上肢感觉神经传导波幅异常较传导速度异常表现明显(P<0.05)。结论:CHEP提示糖尿病神经病变早期可仅累及小纤维神经;CHEP为糖尿病小纤维神经损害提供了新的客观定量方法;糖尿病神经病变不同纤维受损均具有长度依赖性的特点。
Objective： To investigate the effects of the contact heat evoked potential （CHEP） on the early small nerve fiber dysfunction of diabetic neuropathy and the features of CHEP and nerve conduction in diabetic patients （DM）. Methods： The studies of CHEPs and nerve conduction were performed in diabetic patients including 20 DM patients with large nerve fiber dysfunction and 20 DM patients without large nerve fiber dysfunction and 40 normal control subjects. The thermal stimuli were given at right forearm, right dorsum hand and right peroneal area at the same time, respectively. Results： The diabetic patients without large fiber dysfunction through clinical examination had reduced N-P amplitudes of CHEP （P 〈 0.05）, and prolonged N-wave latencies for the leg stimulation compared to those of control group （P 〈 0.05）. There was a significant decrease in CHEP amplitude ratio of lower limb/upper limb in diabetic group than that in control group （P 〈 0.05）. More severe abnormal nerve conduction was found in lower limbs than that in upper limbs in diabetic group （P 〈 0.05）. There were significant abnormalities in amplitude than those of the conduction velocity in diabetic group（P 〈 0.05）. Conclusion： CHEP offers evidence that some of the diabetic patients may have early small fiber dysfunction. CHEP is a new objective potential clinical utility of evaluating diabetic small fiber neuropathy. Both small and large fiber dysfunction in diabetic patients are correlated with the length of nerves.
出处
《天津医药》
CAS
北大核心
2009年第5期374-376,共3页
Tianjin Medical Journal
关键词
诱发电位
糖尿病神经病变
神经传导
糖尿病
2型
evoked potential diabetic neuropathies neural conduction diabetes mellitus, type 2
