摘要
目的探讨足底内侧神经检测在糖尿病周围神经病(diabetic peripheral neuropathy,DPN)早期诊断中的价值。方法选择2018年8~11月于本院内分泌科住院的60例DPN患者进行神经电图检测,比较足底内侧神经、腓浅神经、腓肠神经的电生理特点。结果检测360条感觉神经,足底内侧神经异常率86.7%(104/120),腓浅神经异常率73.3%(88/120),腓肠神经异常率46.7%(56/120),足底内侧神经及腓浅神经异常率显著高于腓肠神经异常率(足底内侧神经 vs 腓肠神经P=0.000,腓浅神经 vs 腓肠神经,P=0.000),足底内侧神经异常率高于腓浅神经异常率,差异无统计学意义(P=0.1);8例患者腓肠神经及腓浅神经检查正常,足底内侧神经显示异常。有临床症状患者39例,足底内侧神经与腓浅神经的检测异常率均显著高于腓肠神经(足底内侧神经 vs 腓肠神经,P=0.000,腓浅神经 vs 腓肠神经,P=0.001),足底内侧神经与腓浅神经的检测异常率无显著差异;无明显临床症状的21例患者中,足底内侧神经异常率显著高于腓浅神经及腓肠神经(P=0.004,P=0.000)。结论足底内侧神经检测对DPN尤其是无症状性的早期DPN诊断有重要价值,进行DPN诊断时如腓肠神经和腓浅神经检查正常应增做足底内侧神经检测以提高早期诊断率。
Objective To investigate the value of medial plantar nerve detection in the early diagnosis of diabetic peripheral neuropathy(DPN).Methods 60 patients with DPN who were admitted to the department of endocrinology from August to November 2018 were examined by electroencephalography.The electrophysiological characteristics of the medial plantar nerve,superficial peroneal nerve and sural nerve were compared.Results 360 sensory nerves were detected.The medial plantar nerve abnormality rate was 86.7%(104/120),the superficial temporal nerve abnormal rate was 73.3%(88/120),and the sural nerve abnormal rate was 46.7%(56/120).The abnormal rate of nerve and superficial nerve was significantly higher than that of sural nerve (medial plantar nerve vs sural nerve,P=0.000,superficial peroneal nerve vs sural nerve,P=0.000).The abnormal rate of medial plantar nerve was higher than that in the superficial peroneal nerve,with no significant difference(P=0.1).In 8 patients,the sural nerve and superficial temporal nerve were normal,and the medial plantar nerve showed abnormalities.In 39 patients with clinical symptoms,the abnormal rate of detection of the medial plantar nerve and superficial temporal nerve was significantly higher than that of the sural nerve(the medial plantar nerve vs sural nerve,P=0.000,superficial peroneal nerve vs sural nerve,P=0.001).There was no significant difference in the abnormal rate of detection between the medial plantar nerve and superficial temporal nerve.In 21 patients without obvious clinical symptoms,the abnormal rate of medial plantar nerve was significantly higher than that of the superficial temporal nerve and sural nerve(P=0.004,P=0.000).Conclusion The medial plantar nerve detection is of great value in the diagnosis of DPN,especially asymptomatic early DPN.For the diagnosis of DPN,if the sural nerve and superficial temporal nerve examination are normal,the medial plantar nerve detection should be added to improve the early diagnosis rate.
作者
黄菲
王爱民
HUANG Fei;WANG Aimin(Department of Rehabilitation,the First Hospital of Changsha,Changsha 410005,China)
出处
《中国现代医生》
2019年第21期36-38,42,共4页
China Modern Doctor
关键词
足底内侧神经
糖尿病周围神经病
早期诊断
肌电图
Medial plantar nerve
Diabetic peripheral neuropathy
Early diagnosis
Electromyography
