糖调节受损周围神经病变的神经电生理特征性分析研究

doi:10.3969/j.issn.1006-6233.2023.05.031

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Abstract Objective: To investigate the characteristic neurophysiological analysis of peripheral neuropathy with impaired glucose regulation and the diagnostic value of the Toronto Clinical Scoring System for the combination of peripheral neuropathy with impaired glucose regulation, and to provide clinicians with information for the early detection of peripheral neuropathy in patients with impaired glucose regulation.Methods: The data of 200 subjects admitted to our hospital from January 2021 to December 2022 were selected as the study group, and all subjects had a score of no less than 6 on the Toronto Clinical Scoring System. There were 68 patients with impaired fasting glucose, 66 patients with abnormal glucose tolerance and 66 patients with type 2 diabetes mellitus. They were divided into three groups, namely impaired fasting glucose + peripheral neuropathy - group A, abnormal glucose tolerance + peripheral neuropathy - group B and diabetic peripheral neuropathy - group C. Meanwhile, 200 cases of healthy physical examiners were selected as the control group during the same period.Results: As seen in the sensory nerve conduction test, the SCV and SNAP wave amplitudes of the median nerve in the study group were significantly lower than those of the control group, and the difference was statistically significant by statistical analysis (P<0.05); the SCV and SNAP wave amplitudes of the median nerve in group C were significantly lower than those of groups A, B and the control group; the SNAP wave amplitudes of the gastrocnemius and superficial peroneal nerve in the study group were significantly lower, and the difference was statistically significant when compared with the control group ( P<0.05); superficial peroneal nerve and peroneal nerve SCV were reduced in both groups B and C, which were statistically significant when compared with the control group (P<0.05); there was no statistically significant difference between the control group and group A in terms of peroneal nerve and superficial peroneal nerve SCV (P>0.05); median, superficial peroneal and peroneal nerve SNAP wave amplitude and SCV in group C were significantly lower than those in group A, which were statistically significant by sub-statistical analysis (P<0.05); the ulnar nerve SNAP and SCV wave amplitudes in group A, group B, group C and control group were not statistically significant by statistical analysis (P>0.05). In the motor nerve conduction test, it was seen that the MCV and CMAP wave amplitudes of the median nerve, tibial nerve and common peroneal nerve were significantly lower in group C compared with the control group, and the DML was seen to be prolonged compared with the control group (P<0.05); in group B compared with the control group, it was seen that the CMAP wave amplitudes of the median nerve, tibial nerve and common peroneal nerve were significantly lower, the DML was seen to be prolonged, and the MCV of the common peroneal nerve and median nerve were significantly lower (P<0.05); CMAP wave amplitude of median nerve and tibial nerve in group A was significantly lower than that in the control group, which was statistically significant (P<0.05); CMAP wave amplitude of median nerve and common peroneal nerve, MCV of tibial nerve and DML prolongation in group C were significantly slower compared with group A (P<0.05); CMAP wave amplitude of costal nerve in group B was significantly lower compared with group A, and DML had prolongation (P<0.05). The mean latency of F waves of ulnar nerve and tibial nerve in groups A, B and C was significantly higher than that in the control group, which was statistically significant by statistical analysis (P<0.05); the emergence rate of F waves of ulnar nerve and tibial nerve in groups A, B and C was significantly lower than that in the control group (P<0.05); the emergence rate of F waves of ulnar nerve and the mean latency of F waves of tibial nerve in group C were prolonged and all decreased significantly; the tibial nerve in group A was compared with group B There was statistical significance (P<0.05) when comparing the tibial nerve in group A with group B; there was statistical significance (P<0.05) when comparing the appearance rate of ulnar nerve, tibial nerve and F wave in group A with group C.Conclusion: In patients with impaired glucose regulation combined with peripheral neuropathy, the abnormalities of lipid metabolism and dyslipidemia are similar to those of patients with DPN, with elevated levels of triglycerides and low-density lipoproteins predominating. The early manifestations of peripheral neuropathy are not obvious, so neurophysiological examination should be performed early in conjunction with the clinical manifestations of the patient to facilitate early detection and treatment.

Key words： Impaired glucose regulation Nerve conduction detection Peripheral neuropathy Glycosylated hemoglobin

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.05.031 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I5/855