摘要
目的通过对比糖尿病周围神经病变(DPN)患者与正常人群周围神经声像图,总结DPN的一般声像图特征及特异性超声表现;高频超声(HFUS)与肌电图(EMG)进行相关性分析,印证HFUS对DPN的诊断价值;同时观察糖尿病(DM)患者DPN与足背动脉受累是否具有相关性。方法选择内蒙古医科大学附属医院DPN患者30例[A组,男性22例,女性8例;年龄(56.40±8.77)岁]和同期体检或诊治其他疾病不伴发DM及DPN患者30例[B组,正常对照组,男性20例,女性10例;年龄(55.33±10.10)岁],以及有DM无DPN患者30例[C组,男性22例,女性8例;年龄(54.90±10.48)岁)]。3组行超声检查,A组和B组观察和记录双上肢正中神经、尺神经、双下肢坐骨神经、胫神经、腓总神经、腓肠神经前后径(D1)、左右径(D2)、横截面积(CSA)、神经被膜、神经束膜、内部回声及彩色多普勒(CDFI)情况;同时A组患者进行EMG检查,记录上述神经的潜伏期、波幅及神经传导速度;A组和C组进行双下肢足背动脉的超声检查,观察其管径、斑块、内中膜情况,记录其收缩期峰值流速(PSV)、搏动指数(PI)及阻力指数(RI)。结果 B组各神经显示清晰,横断面表现为边界清晰的筛网状结构,神经被膜及神经束膜表现为线状高回声,纵断面表现为由平行线状高回声(神经束膜)分割成的断续管状低回声(神经束);A组各神经肿大增粗、内部回声减低、神经被膜及神经束膜线状高回声模糊不清,D1、D2、CSA均较B组增大,血流信号增多(P<0.05)。A组神经(正中神经、尺神经、腓总神经、胫神经、腓肠神经)CSA与EMG潜伏期呈正相关(r=0.527、0.910、0.702、0.581、0.793),与电位波幅呈负相关(r=-0.676、-0.298、-0.666、-0.439、-0.586),与神经传导速度呈负相关(r=-0.766、-0.853、-0.716、-0.877、-0.774);A组及C组足背动脉均有患者出现动脉粥样硬化表现,表现为内中膜不平整,局段或弥漫性增厚、单发或多发斑块,PSV、PI、RI随�
Objective To study the general and specific ultrasonographic findings of diabetic peripheral neuropathy（DPN） with normal persons, and explore the value of high-frequency ultrasound（HFUS） in diagnosis of DPN by comparing findings on HFUS with electromyography（EMG）, and analyze the correlation between peripheral nerve and dorsalis pedis of diabetes mellitus（DM）.Methods A total of 30 DPN patients[group A, which included 22 males and 8 females, aged（56.40 ± 8.77） years old], 30 physical examination patients or with other diseases without DM and DPN during the same period as normal control group[group B, which included 20 males and 10 females, aged（55.33 ± 10.10） years old], 30 DM without DPN patients[group C, which included22 males and 8 female, aged（54.90 ± 10.48） years old] were enrolled. Patients in group A and B group were performed by ultrasound,then the data of double upper limb median nerve, ulnar nerve, double lower extremity sciatic nerve, tibial nerve, common peroneal nerve, anteroposterior diameter of sural nerve（D1）, transversal diameter（D2）, cross sectional area（CSA）, epineurium,perineurium, internal echogenerosity and color Doppler flowing imaging（CDFI） was observed and recorded; Group A were performed by EMG examination. The latency, amplitude and conduction velocity of nerves mentioned above were recorded;Ultrasonography of bilateral dorsal arteries of double lower limbs in group A and group Cwere performed; the diameter, plaque and intima-media was observed; and peak systolic velocity（PSV）, pulse index（PI） and resistance index（RI） was recorded.Results The nerves in group B showed clear, mesh-like structure with clearly boundary; the epineurium and perineurium showed as linear hyperechogenicity in cross section; the longitudinal section showed intermittent tubular hypoechoic（nerve tract） divided by parallel linear hyperechogenicity（perineurium）. Nerves of group A swelled and thickened with internal hypoechogenicity echo, blurring of ec
出处
《生物医学工程与临床》
CAS
2017年第1期30-37,共8页
Biomedical Engineering and Clinical Medicine
基金
国家自然科学基金资助项目(81360213)
内蒙古自然科学基金面上项目(2015MS0818)
关键词
超声
糖尿病
周围神经病变
足背动脉
肌电图
ultrasound
diabetes mellitus
peripheral neuropathy
arteria dorsalis pedis
electromyography
