中国神经再生研究(英文版) ›› 2014, Vol. 9 ›› Issue (14): 1389-1394.doi: 10.4103/1673-5374.137593

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

糖尿病性周围神经病变早期感觉神经动作电位波幅的变化:500例分析

  

  • 收稿日期:2014-04-29 出版日期:2014-07-25 发布日期:2014-07-25
  • 基金资助:

    云南省科技项目(2011C08).

Amplitude of sensory nerve action potential in early stage diabetic peripheral neuropathy: an analysis of 500 cases

Yunqian Zhang 1, Jintao Li 2, Tingjuan Wang 1, Jianlin Wang 1   

  1. 1 Department of Neurology, the Fourth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
    2 Neuroscience Institute, Kunming Medical University, Kunming, Yunnan Province, China
  • Received:2014-04-29 Online:2014-07-25 Published:2014-07-25
  • Contact: Jianlin Wang, M.D., Department of Neurology, the Fourth Affiliated Hospital of Kunming Medical University, Kunming 650021, Yunnan Province, China,2605691027@qq.com.
  • Supported by:

    This work is supported by the Science and Research Fund of Academic Department in Yunnan Province in China, No. 2011C08.

摘要:

糖尿病患者周围神经病变的早期发现是修复治疗的关键,为此,我们招募了2008-06/2013-09在昆明医科大学第四附属医院就诊的500例糖尿病患者,其中221例患者出现周围神经病变,279例患者无周围神经病变的临床症状。检测神经传导显示,与正常对照者相比,糖尿病患者正中神经、尺神经、胫神经和腓总神经运动潜伏期延长,而感觉神经传导速度缓慢下降、感觉神经动作电位及复合肌肉动作电位波振幅显著降低,且周围神经病变患者的变化更为明显。500例糖尿病患者中358例患者(71.6%)出现神经传导检查异常,其中腓总神经最为明显,且糖尿病患者感觉神经异常比率较运动神经高,感觉神经动作电位波幅对糖尿病患者周围神经病变最为敏感。提示糖尿病周围神经病变患者早期无临床症状阶段仍有不同程度的神经传导特性改变。

关键词: 神经再生, 周围神经损伤, 糖尿病周围神经病变, 神经传导特性分析, 电生理, 感觉神经, 运动神经, 早期诊断

Abstract:

Early diagnosis of diabetic peripheral neuropathy is important for the successful treatment of diabetes mellitus. In the present study, we recruited 500 diabetic patients from the Fourth Affiliated Hospital of Kunming Medical University in China from June 2008 to September 2013: 221 cases showed symptoms of peripheral neuropathy (symptomatic group) and 279 cases had no symptoms of peripheral impairment (asymptomatic group). One hundred healthy control subjects were also recruited. Nerve conduction studies revealed that distal motor latency was longer, sensory nerve conduction velocity was slower, and sensory nerve action potential and amplitude of compound muscle action potential were significantly lower in the median, ulnar, posterior tibial and common peroneal nerve in the diabetic groups compared with control subjects. Moreover, the alterations were more obvious in patients with symptoms of peripheral neuropathy. Of the 500 diabetic patients, neural conduction abnormalities were detected in 358 cases (71.6%), among which impairment of the common peroneal nerve was most prominent. Sensory nerve abnormality was more obvious than motor nerve abnormality in the diabetic groups. The amplitude of sensory nerve action potential was the most sensitive measure of peripheral neuropathy. Our results reveal that varying degrees of nerve conduction changes are present in the early, asymptomatic stage of diabetic peripheral neuropathy.

Key words: nerve regeneration, peripheral nerve injury, diabetic peripheral neuropathy, neural conduction, electrophysiology, sensory nerve, motor nerve, early diagnosis, neural regeneration