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目的探讨神经传导速度及交感皮肤反应(SSR)在糖尿病性周围神经病(DPN)诊断中的价值。方法对36例DPN患者进行神经电图检查,包括运动神经传导速度(MCV)、感觉神经传导速度(SCV)及交感皮肤反应(SSR)检测。结果共检查36例患者216条神经,其中MCV检测108条神经,MCV减慢32条,MCV减慢合并远端潜伏期延长8条,复合肌肉动作电位(CMAP)波幅下降4条,异常率40．7％; SCV检测108条神经,SCV减慢42条,未引出电位7条,SCV减慢伴波幅下降6条,异常率50．9％;SSR检测36例72侧肢体,其中有4例上、下肢均未引出SSR,22例38肢SSR潜伏期延长,波幅下降,异常率63．8％,10例无自主神经症状患者中有3例SSR异常,异常率30％。结论NCV及SSR检测为DPN自主神经及周围神经早期病变,尤其是为亚临床病变提供了客观依据,多个参数相结合有助于提高早期病变的阳性检出率。
Objective To investigate the value of nerve conduction velocity and sympathetic skin reaction (SSR) in the diagnosis of diabetic peripheral neuropathy (DPN). Methods 36 patients with DPN were examined by electrogastrogram, including motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV) and sympathetic skin reaction (SSR). Results A total of 216 neurons were examined in 36 patients. Among them, 108 neurons were detected by MCV. The MCV was decreased by 32, the MCV was slowed down and the distal latency was prolonged by 8. The amplitude of compound muscle action potential (CMAP) was decreased by 4 and the abnormality rate was 40. 7%; SCV detected 108 nerves, SCV slowed down 42, no lead potential 7, SCV slowed down with amplitude decreased 6, the abnormal rate of 50.9%; SSR detection of 36 cases of 72 limbs, of which 4 cases No SSR was induced in the lower extremities. The SSR latency of 22 limbs with 38 limbs was prolonged and the amplitude was decreased with an abnormality rate of 63.8%. Three of 10 patients without autonomic symptoms had abnormal SSR with an abnormal rate of 30%. Conclusion The detection of NCV and SSR is an early detection of DPN autonomic nerve and peripheral nerve lesions, especially for subclinical lesions. The combination of multiple parameters can help improve the positive detection rate of early lesions.