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目的探讨几种神经肌电图检测方法在早期糖尿病患者诊断周围神经损害中的敏感性。方法对164例病程<5年的糖尿病患者的正中神经、腓总神经、胫神经运动神经传导速度(MCV)与正中、腓浅、腓肠感觉神经传导速度(SCV)、正中神经F波、胫神经H反射及交感神经皮肤反应(SSR)采用神经电生理方法进行测定。结果 164例患者胫神经的H反射及下肢SSR总异常率均较高,且异常率随病程的增加而增加;病程>3年的糖尿病患者双下肢腓总神经MCV与腓浅神经SCV异常率也很可观。结论胫神经H反射是糖尿病早期周围神经病变最敏感指标,SSR的异常亦不可忽视,要综合神经肌电图几项检查结果 ,正确评价糖尿病周围神经功能状态。
Objective To investigate the sensitivity of several neuroelectrogram detection methods in the diagnosis of peripheral nerve damage in patients with early stage diabetes mellitus. Methods The median nerve, common peroneal nerve and tibial nerve motor nerve conduction velocity (MCV) were measured in 164 patients with diabetes mellitus with less than 5 years of disease. The sensory nerve conduction velocity (SCV), mesangial F wave, shin Nerve H reflex and sympathetic skin reaction (SSR) were measured by electrophysiological methods. Results The 164 cases of tibial nerve H reflex and lower extremity SSR total abnormal rate were higher, and the abnormal rate increased with the increase of course; course of disease> 3 years of diabetic lower extremity common peroneal nerve MCV and peroneal nerve SCV abnormal rate Very impressive. Conclusion H-reflex of the tibial nerve is the most sensitive index of peripheral neuropathy in early stage of diabetes mellitus, and the abnormality of SSR can not be neglected. We should synthesize several test results of neuromuscular electrogram to correctly evaluate the functional status of diabetic peripheral neurons.