糖尿病患者正中神经的超声评估

doi:10.3969/j.issn.1006-9771.2021.03.014

摘要/Abstract

摘要： 目的

观察糖尿病患者正中神经高频超声参数特征，以及超声特征与电生理结果的相关性。

方法

2019年6月至11月，本院糖尿病住院患者79例根据是否存在糖尿病周围神经病变(DPN)分为DPN组(n = 37)和非DPN组(n = 42)。采用高频超声分别于距右腕横纹5 cm和10 cm处测量正中神经横截面积(CSA)、低回声区域比例(HA)；行右侧正中神经传导检查，记录潜伏期和传导速度。

结果

DPN组CSA-5、CSA-10和HA-10大于非DPN组(|Z| > 2.282, P < 0.05)。所有患者HA-5与正中神经运动传导潜伏期呈正相关(r = 0.264, P < 0.05)，与正中神经运动传导速度呈负相关(r = -0.270, P < 0.05)。HA-10与正中神经感觉传导远端潜伏期异常(r = 0.234, P < 0.05)和传导速度异常(r = 0.363, P < 0.01)呈正相关，与正中神经运动传导潜伏期呈正相关(r = 0.235, P < 0.05)，与正中神经运动传导速度呈负相关(r = -0.255, P < 0.05)。

结论

DPN存在超声图像特征改变，部分改变与电生理结果相关，可为糖尿病正中神经病变的诊断提供参考。

关键词: 糖尿病周围神经病, 神经超声, 正中神经

Abstract: Objective

To measure the parameters of median nerve under ultrasound in patients with diabetes mellitus to explore the relationship between ultrasonic parameters and nerve conduction study.

Methods

From June to November, 2019, 79 diabetic patients were divided into diabetic peripheral neuropathy (DPN) group (n = 37) and non-DPN group (n = 42) according to the diagnosis. Their right median nerve were measured cross-sectional area (CSA) and the proportion of hypoechoic areas (HA) 5 cm and 10 cm proximal to the wrist (CSA-5, CSA-10, HA-5 and HA-10, respectively) with sonography; while the conductive latency and velocity of right median nerves were measured with nerve conductive study.

Results

CSA-5, CSA-10 and HA-10 were more in DPN group than in non-DPN group (|Z| > 2.282, P < 0.05). HA-5 correlated with the motor conductive latency (r = 0.264, P < 0.05) and velocity (r = -0.270, P < 0.05); HA-10 correlated with the abnormal sensory conductive latency (r = 0.234, P < 0.05) and velocity (r = 0.363, P < 0.01), and the motor conductive latency (r = 0.235, P < 0.05) and velocity (r = -0.255, P < 0.05).

Conclusion

DPN can be found under sonography, some of them are related with the nerve electrophysiology, which may be a useful tool to screen DPN.

Key words: diabetic peripheral neuropathy, nerve sonography, median nerve

中图分类号:

R587.2

王小泉,刘超然,王宁华. 糖尿病患者正中神经的超声评估[J]. 《中国康复理论与实践》, 2021, 27(3): 329-333.

Xiao-quan WANG,Chao-ran LIU,Ning-hua WANG. Sonographic Evaluation of Median Nerve for Diabetics[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(3): 329-333.

图/表 4

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组别	n	CSA-5 (mm²)	CSA-10 (mm²)	HA-5 (%)	HA-10 (%)
DPN组	37	6.502(6.015~8.217)	6.572(6.002~12.120)	54.86±2.13	55.77±2.85
非DPN组	42	6.199(5.698~8.370)	6.227(5.406~8.743)	54.30±2.29	54.49±2.14
Z/t值		-2.535	-3.232	-1.125	-2.282
P值		0.011	0.001	0.264	0.025

超声参数	感觉传导潜伏期		感觉传导速度		运动传导潜伏期		运动传导速度
超声参数	r值	P值	r值	P值	r值	P值	r值	P值
CSA-5	0.030	0.795	0.154	0.177	0.172	0.129	0.061	0.592
CSA-10	0.151	0.185	0.027	0.815	0.135	0.237	-0.118	0.301
HA-5	0.008	0.946	0.126	0.270	0.264	0.019	-0.270	0.016
HA-10	0.234	0.038	0.363	0.001	0.235	0.037	-0.255	0.024

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