摘要
目的评估泌汗神经功能检测在诊断2型糖尿病(T2DM)患者早期周围神经病变中的价值。方法分别采用DNS评分法和欧米诺汗印法(新型诊断膏贴,Neuropad)对218例T2DM患者进行外周神经病变评估及泌汗神经功能检测,计算欧米诺汗印法、10g单纤丝、振动觉、温度觉及针刺痛觉的单项检查相对于DNS评分法对周围神经病变诊断的灵敏度和特异度。结果糖尿病周围神经病变组欧米诺汗印法变色时间为19·1±8·1min,显著高于糖尿病无神经病变组的8·3±1·8min和对照组的3·9±0·8min(P<0·01);欧米诺汗印法测得的周围神经病变发病率为61·9%略高于DNS测得的57·8%。相对于DNS评分法,欧米诺汗印法诊断周围神经病变的敏感度为92·8%,特异度为82·2%阳性预告值82·6%;单项的10g单纤丝、振动觉、足背部温度觉及痛觉测试的灵敏度分别为69·0%、33·3%、67·4%和57·1%,特异度分别为81·5%、90·2%、80·4%和84·8%。欧米诺汗印法变色时间与DNS评分呈显著正相关(r=0·46,P<0·01),优于其他4种单项检查。结论欧米诺汗印法是一种简易、有重要参考价值的检测方法,其对糖尿病患者足部泌汗功能的检测有助于糖尿病周围神经病变的早期筛查。
Objective To evaluate the test for the function of sudomotor nerve in the diagnosis of diabetic peripheral neuropathy. Methods The function of sudomotor nerve in 218 diabetic patients was detected and evaluated by Neuropad （A new diagnostic tool） and diabetic neuropathy score （DNS）. the sensitivity and specificity of the Neuropad, 10 g monofilament, vibration sensation, temperature sensation and stabbing pain sensation for the diagnosis peripheral neuropathy were evaluated and compared with DNS diagnostic value, respectively. Results Time for complete colour change of Neuropad in patients with peripheral neuropathy was 19.1±8.1 min, which was significantly higher than that without peripheral neuropathy （8.3 ± 1.8 min, P 〈 0.01） and the control group （3.9 ± 0.8 min, P〈0.01）. The morbidity of peripheral neuropathy using the Neuropad （61.9 % ） was a bit higher than that using the DNS （57.8%）. Compared with the DNS diagnostic value, the sensitivity, specificity and predictive value of positive list of Neuropad in the diagnosis of peripheral neuropathy was 92.8%, 82.2% and 82.6% respectively. The sensitivity of 10 g monofilament, vibration sensation, temperature sensation and stabbing pain sensation was 69.0 %, 33.3 %, 67.4 % and 57.1% respectively. The specificity Of 10g monofilament, vibration sensation, temperature sensation and stabbing pain sensation was 81.5%, 90.2%, 80.4% and 84.8% respectively. Time for complete colour change of Neuropad has significantly positive correlation with the DNS value and was better than the other 4 tests. Conclusions The Neuropad is a screening convenient and valuable test. The test for the sudomotor function of foot is helpful for the early screening diagnosis of peripheral neuropathy. The quantitative characteristics of the Neuropad can be used in the preliminary evaluation of the peripheral neuropathy.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2007年第6期364-366,共3页
Chinese Journal of Diabetes
