论文部分内容阅读
目的:糖尿病周围神经病变(DPN)是糖尿病最常见的慢性并发症之一,危害严重,而大部分患者早期无症状,以致延误了早期诊断,失去了早期治疗的机会。目前DPN的筛查方法众多,但尚无确定有效的筛查方法。震动感觉阈值检查(VPT)在发达国家已广泛应用于糖尿病神经病变的临床筛查,但目前国内很少应用。本文旨在探讨VPT对老年糖尿病周围神经病变的临床应用价值。方法:采用数字震动感觉阈值检查仪、128 Hz音叉检测40例老年2型糖尿病患者(DM组)和36例非糖尿病老年人(对照组)的VPT和音叉震动觉,与神经传导速度(NCV)进行对比分析。结果:40例DM组中有周围神经病症状18人(45%),音叉震动觉减弱17例(42.5%),VPT异常21例(52.5%),NCV异常24例(60%)。以NCV检查结果作为诊断金标准,评价VPT的敏感性79.2%,特异性87.5%。结论:VPT检查是一种特异、敏感、有效、简便的DPN早期筛查方法,能及早发现严重并发症的高风险人群,适合常规的门诊筛查。VPT检测结合临床症状、体征,能更方便、可靠地诊断老年糖尿病周围神经病变,对于DPN的疾病风险、早期干预、评价预后非常重要。
OBJECTIVE: Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus, which is devastating. However, most patients are asymptomatic early, which delays the early diagnosis and loses the chance of early treatment. At present, there are many screening methods for DPN, but there is no definite and effective screening method. Vibration sensory threshold test (VPT) has been widely used in clinical trials of diabetic neuropathy in developed countries, but is rarely used in our country at present. This article aims to investigate the clinical value of VPT on senile diabetic peripheral neuropathy. Methods: VPT and tuning fork vibration of 40 senile type 2 diabetic patients (DM group) and 36 non-diabetic senile patients (control group) were measured with digital vibration sensory threshold tester and 128 Hz tuning fork to detect the relationship between nerve conduction velocity (NCV) For comparative analysis. Results: There were 18 patients (45%) with peripheral neuropathy in 40 DM patients, 17 patients (42.5%) with vibration of tuning fork, 21 patients with VPT abnormality (52.5%) and 24 patients with abnormal NCV (60%). To NCV test results as the gold standard for diagnosis, evaluation of VPT sensitivity 79.2%, specificity 87.5%. Conclusion: VPT is a specific, sensitive, effective and simple method for early screening of DPN. It can detect the high risk of serious complications early and is suitable for routine outpatient screening. VPT combined with clinical symptoms and signs, more convenient and reliable diagnosis of diabetic peripheral neuropathy in elderly patients with DPN disease risk, early intervention, evaluation of prognosis is very important.