【摘要】：目的通過(guò)對(duì)比糖尿病周圍神經(jīng)病變的臨床診斷標(biāo)準(zhǔn),評(píng)估SUDOSCAN在2型糖尿病遠(yuǎn)端對(duì)稱性多發(fā)性神經(jīng)病變的診斷價(jià)值。方法實(shí)驗(yàn)組:選取2015年8月~2016年7月在青島大學(xué)附屬醫(yī)院內(nèi)分泌科住院的2型糖尿病患者130例,根據(jù)糖尿病遠(yuǎn)端對(duì)稱性多發(fā)性神經(jīng)病變的診斷標(biāo)準(zhǔn)將其分為兩組:周圍神經(jīng)病變組50例(DPN組)和無(wú)周圍神經(jīng)病變組80例(NDPN組),對(duì)照組:選取青島大學(xué)附屬醫(yī)院體檢中心查體的健康志愿者80例(NC組)。采用SUDOSCAN檢測(cè)儀對(duì)所有受試者進(jìn)行泌汗神經(jīng)功能檢查,觀察3組雙手及雙足平均電化學(xué)皮膚電導(dǎo)率(ESC,單位為μS),采用單因素方差分析比較各組織間手足ESC的差異性,與此同時(shí)對(duì)感覺神經(jīng)傳導(dǎo)速度與手足ESC進(jìn)行相關(guān)性分析,將手足ESC與糖尿病病程進(jìn)行相關(guān)分析,并將年齡與糖尿病病程進(jìn)行相關(guān)性分析。結(jié)果(1)所有受試者在進(jìn)行SUDOSCAN檢測(cè)過(guò)程中無(wú)任何不適感覺,無(wú)手掌及足底發(fā)紅,所有受試者在進(jìn)行該檢查時(shí)沒有任何不良事件發(fā)生。(2)NC組與2型糖尿病患者手平均ESC值分別為(79.1±10.4)μS和(59.7±18.1)μS;足平均ESC值分別為(82.0±8.2)μS和(62.1±21.8)μS,兩組之間比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)DPN組、NDPN組手平均ESC值分別為(53.2±18.9)μS和(63.7±16.5)μS;足平均ESC值分別為(53.5±24.4)μS和(67.4±18.2)μS,兩組之間比較差異均有統(tǒng)計(jì)學(xué)意義(均P0.05);(4)所有受試者的手平均ESC值與感覺神經(jīng)傳導(dǎo)速度(SCV)結(jié)果均呈正相關(guān),相關(guān)系數(shù)為r=0.425,(P0.01);所有受試者的足平均ESC值與感覺神經(jīng)傳導(dǎo)速度(SCV)結(jié)果均呈正相關(guān),相關(guān)系數(shù)r=0.445(P0.01)。(5)糖尿病患者的手平均ESC與病程呈明顯負(fù)相關(guān),相關(guān)系數(shù)為r=-0.350,(P0.01),足平均ESC與病程亦呈現(xiàn)明顯負(fù)相關(guān),相關(guān)系數(shù)為r=-0.428,(r=-0.428,P0.01);(6)糖尿病患者的病程與年齡呈正相關(guān),相關(guān)系數(shù)為r=0.330,P0.01;(7)手ESC診斷遠(yuǎn)端對(duì)稱性糖尿病神經(jīng)病變ROC曲線下面積分別為0.785,截?cái)嘀禐?4.5μS,敏感度為72.0%,特異度為73.7%;足ESC診斷遠(yuǎn)端對(duì)稱性糖尿病神經(jīng)病變ROC曲線下面積分別為0.768,截?cái)嘀禐?0.5μS,敏感度為60.0%,特異度為83.7%(均P0.01)。結(jié)論(1)SUDOSCAN檢測(cè)結(jié)果與糖尿病病程密切相關(guān),糖尿病病程越長(zhǎng)泌汗神經(jīng)受損傷程度越重,SUDOSCAN檢測(cè)的手足ESC值也就越低。(2)SUDOSCAN檢測(cè)的方法簡(jiǎn)便易行、結(jié)果量化、與傳統(tǒng)糖尿病神經(jīng)病變檢查(感覺神經(jīng)傳導(dǎo)速度檢查)結(jié)果具有較高的一致性。(3)SUDOSCAN對(duì)于2型糖尿病對(duì)稱多發(fā)性神經(jīng)病變具有一定的診斷價(jià)值,可用于中國(guó)人群糖尿病神經(jīng)病變的診斷。
[Abstract]:Objective to evaluate the diagnostic value of SUDOSCAN in type 2 diabetes mellitus with symmetrical polyneuropathy by comparing the clinical diagnostic criteria of diabetic peripheral neuropathy. Methods: from August 2015 to July 2016, 130 patients with type 2 diabetes mellitus were enrolled in the Department of Endocrinology, affiliated Hospital of Qingdao University. According to the diagnostic criteria of diabetic distal symmetrical polyneuropathy, they were divided into two groups: peripheral neuropathy group (n = 50, DPN group) and non-peripheral neuropathy group (n = 80, NDPN group). Control group: 80 healthy volunteers (NC group) were selected from the physical examination center of affiliated Hospital of Qingdao University. The perspiration nerve function of all subjects was examined by SUDOSCAN detector. The average electrochemical skin conductivity of hands and feet was observed in three groups (ESC, unit 渭 S),). The difference of ESC between hands and feet was compared by single factor variance analysis. At the same time, the correlation between sensory nerve conduction velocity and hand and foot ESC was analyzed, and the correlation between hand and foot ESC and the course of diabetes was analyzed, and the correlation between age and the course of diabetes was analyzed. Results (1) there was no discomfort, no redness of palm and foot in all subjects during SUDOSCAN test. No adverse events occurred in all subjects. (2) the average ESC values of hands in NC group and type 2 diabetic patients were (79.1 鹵10.4) 渭 S and (59.7 鹵18.1) 渭 S, respectively. The average ESC values of foot were (82.0 鹵8.2) 渭 S and (62.1 鹵21.8) 渭 S, respectively. there was significant difference between the two groups (P 0.05). (3). There was significant difference between the two groups (P 0.05). (3). The average ESC values of hands in NDPN group were (53.2 鹵18.9) 渭 S and (63.7 鹵16.5) 渭 S, respectively. The average ESC values of foot were (53.5 鹵24.4) 渭 S and (67.4 鹵18.2) 渭 S, respectively. there was significant difference between the two groups (P 0.05). (4) the hand average ESC value of all subjects was positively correlated with the results of sensory nerve conduction velocity (SCV), and the correlation coefficient was r 鈮，

本文編號(hào)：2496198