论文部分内容阅读
目的探讨交感神经皮肤反应(SSR)在儿童糖尿病周围神经病交感神经纤维病变早期诊断的应用价值。方法对35例1型糖尿病(T1DM)儿童和30例健康儿童四肢分别进行电刺激SSR检测,测量每个肢体的平均起始潜伏期和峰-峰波幅,并比较2组各肢体的SSR起始潜伏期及峰-峰波幅差异。同时对T1DM组儿童进行神经传导速度(NCV)的检测,并对NCV检测异常率与SSR检测异常率进行比较。另外,还对有酮症酸中毒(DKA)史和无DKA史的2组患儿SSR检测异常结果进行比较。结果 T1DM组患儿各肢体SSR起始潜伏期均较健康对照组明显延长(Pa<0.05)。健康对照组30例四肢均可引出SSR波形,T1DM组31例患儿四肢均可引出SSR波形;4例患儿至少有一肢不能引出SSR波形(11.4%),其中2例患儿四肢均未引出SSR波形(5.7%);21例(60%)患儿至少有一肢SSR缺失或起始潜伏期异常,其中15例(71.4%)有DKA史,高于无DKA患儿异常检出率(6例,42.9%),但2组比较无统计学差异。T1DM组患儿NCV检测异常10例(28.6%),较SSR起始潜伏期的检出异常率低,两者比较差异无统计学意义(P>0.05)。结论 SSR检测可早期发现糖尿病周围神经病交感神经小纤维病变,较NCV敏感。
Objective To investigate the value of sympathetic skin reaction (SSR) in the early diagnosis of sympathetic nerve fiberopathy of diabetic peripheral neuropathy in children. Methods 35 cases of type 1 diabetes (T1DM) children and 30 healthy children limbs were subjected to electrical stimulation SSR test to measure the average initial latency and peak-to-peak amplitude of each limb, and compared the limbs SSR onset latency And peak - peak amplitude differences. At the same time, the nerve conduction velocity (NCV) was detected in T1DM children, and the abnormality rate of NCV was compared with that of SSR. In addition, the results of SSR testing were compared between two groups of children who had ketoacidosis (DKA) history and no DKA history. Results The onset latency of SSR in each limb of T1DM group was longer than that of healthy control group (Pa0.05). SSR waveforms were found in all 30 limbs in the healthy control group, SSR waveforms were found in all the 31 limbs in T1DM group. SSR waveforms were not induced in at least one of the four limbs (11.4%) in 4 of the 4 children, of which 2 limbs were not elicited SSR waveforms (5.7%); at least one of 21 cases (60%) had abnormal SSR or initial latent period, of which 15 cases (71.4%) had DKA history, which was higher than those without DKA , 42.9%), but no significant difference between the two groups. There were 10 cases (28.6%) with abnormal NCV detection in T1DM group, which was lower than that of SSR initial incubation period. There was no significant difference between the two groups (P> 0.05). Conclusion SSR detection of early detection of diabetic peripheral neuropathy sympathetic fibrosis, NCV sensitive.