摘要
目的探讨皮肤交感反应(sympathetic skin response,SSR)在诊断糖尿病性周围神经病中的临床价值。方法81例T2DM患者进行SSR与常规电生理检测,30例健康志愿者作为对照。比较SSR与常规电生理检测的敏感性,并分析SSR与病程、亚临床的关系。结果①与对照组比较,T2DM组SSR起始潜伏期及波幅的差异均有统计学意义(P<0.05);②T2DM组病程<5年与病程≥5年比较,潜伏期及波幅差异均无统计学意义(P>0.05);③T2DM组SSR总异常率85.1%(69/81),常规电生理检测总异常率58.0%(47/81)。SSR联合常规电生理检测的异常率为95.1%(77/81);④21例无明显临床自觉症状的T2DM患者中SSR异常率(85.7%)高于常规电生理检测异常率42.9%(P<0.05);⑤81例T2DM患者中8例仅有常规电生理的异常,而无SSR的异常。结论①SSR检测方法较常规电生理检测异常率高,尤其在DM病程早期;②SSR对于亚临床症状的诊断具有重要意义;③SSR不能取代NCV,两者相结合可明显提高DPN的早期诊断率。
Objective To explore the clinical value of sympathetic skin response in diagnosing diabetic peripheral neuropathy and analyze its relationship with conventional nerve electrophysiology, diabetes duration,and subclinical lesion. Methods SSR and conventional nerve electrophysiology tests were performed in 81 patients with type 2 diabetic mellitus and in 30 age-and gender-matched healthy volunteers at the same time. Results （1）There are significant difference of the onset latencies and peak amplitudes of SSR between two groups（ P 〈 0.05） ;（2）There was no significant difference of the SSR onset latencies and peak amplitudes in two groups（diabetes duration over 5 years or diabetes duration below 5 years） ; （3）69（85.1% ） of 81 patients with T2DM showed abnormal SSR at least one limb, 47（58.0% ） of 81 patients with T2DM showed abnormal conventional nerve electrophysiology methods. Abnormal rate of combination test of SSR and conventional nerve electrophysiology methods was 95.1%;（4） In the T2DM group, there were 21 patients without obviously clinical subjective symptom, 18 patients（85.7 % ） with the abnormality of SSR, and 9 patients（42.9 % ） with the abnormality of conventional nerve electrophysiology methods; （5）In the T2DM group, there were 8 patients only with the abnormality of conventional nerve electrophysiology methods, but without the abnormality of SSR. Conclusion （1）The detection rate of SSR is higher than that of conventional nerve electrophysiology methods, especially in early course of diabetes mellitus; （2）SSR plays an important part in the diagnosis of DPN patients that without clinical symptom; （3）SSR can not substitute conventional nerve electrophysiology methods, the diagnostic sensitivity can be improved if all the parameters are used together.
出处
《宁夏医科大学学报》
2009年第1期32-34,共3页
Journal of Ningxia Medical University
关键词
皮肤交感反应
周围神经病
糖尿病
sympathetic skin response
diabetic peripheral neuropathy
diagnosis
