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中国临床研究:2019,32(9):1193-1196
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剪切波弹性成像技术评估2型糖尿病患者下肢神经病变
(兰州大学第二医院超声科,甘肃 兰州 730030)
Evaluation of shear wave elastography for lower extremity neuropathy in patients with type 2 diabetes
(Department of Ultrasound,the Second Hospital of Lanzhou University,Lanzhou,Gansu 730030,China)
摘要
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投稿时间:2019-02-28   网络发布日期:2019-09-20
中文摘要: 目的应用剪切波弹性成像技术(SWE)探讨2型糖尿病周围神经病变(DPN)患者下肢神经的改变。方法收集2017年9月至2018年2月收治的2型糖尿病(T2DM)患者119例,分为非DPN组58例及DPN组61例;另选取同期健康志愿者60例,超声检查下肢内踝上方5 cm处胫神经(TN)及外踝上方5 cm处腓肠神经,测量其厚径、宽径、周长、截面积,并应用SWE测量杨氏弹性模量值(EI),比较3组间胫神经、腓肠神经上述参数的差异。绘制ROC曲线,分析以EI值诊断DPN的敏感度及特异度。结果胫神经三组间厚径比较差异有统计学意义(P<0.05),DPN组厚径高于正常组和非DPN组(P<0.05)。腓肠神经三组间厚径比较差异有统计学意义(P<0.05),DPN组厚径高于正常组(P<0.05)。三组间胫神经及腓肠神经宽径、截面积、周长、EI值比较差异均有统计学意义(P<0.01),且DPN组高于非DPN组,非DPN组高于正常组。当胫神经、腓肠神经EI值的阈值分别取52.45 kPa、52.05 kPa时,ROC曲线下面积及其95%可信区间分别是0.928(0.884~0.972)、0.946(0.906~0.986);诊断DPN的敏感度和特异度分别为90.00%和81.70%,诊断非DPN的敏感度和特异度分别为95.00%和85.00%。结论SWE可以通过评估2型糖尿病患者下肢神经的硬度,为DPN的早期诊断提供一定的临床依据。
Abstract:Objective Using shear wave elastography (SWE) to evaluate the changes of lower extremity neuropathy in patients with type 2 diabetic peripheral neuropathy(DPN). Methods Total 119 patients with type 2 diabetes mellitus (T2DM) admitted from September 2017 to February 2018 were divided into non-DPN group (n=58) and DPN group (n=61),and 60 healthy volunteers were served as control group at the same period.The thickness,width,circumference and cross-sectional area of tibial nerve (TN) 5 cm above the medial malleolus and sural nerve (SN) 5 cm above the lateral malleolus were measured by ultrasonography,and elastic modulus (EI) value was measured by SWE and the differences of above parameters of TN and SN among the three groups were compared.The ROC was used to analyze the sensitivity and specificity of EI value in differential diagnosis of DPN and non-DPN. Results The thickness of TN in DPN group was significantly higher than that in normal group and non-DPN group(P<0.05),and the thickness of SN in DPN group was significantly higher than that in normal group (all P<0.05).The width,cross-sectional area,perimeter and EI value of TN and SN in DPN group were significantly higher than those in non-DPN group,they in non-DPN group were significantly higher than those in control group(all P<0.01).When the threshold of EI value of TN and SN was 52.45 kPa and 52.05 kPa respectively,the area under the ROC and its 95% confidence interval was 0.928(0.884-0.972) and 0.946(0.906-0.986),respectively.The sensitivity and specificity of diagnosing DPN were 90.00% and 81.70% respectively,and those of diagnosing non-DPN were 95.00% and 85.00%,respectively. Conclusion SWE can provide a certain clinical basis for early diagnosis of DPN by evaluating peripheral nerves of lower extremity in T2DM patients.
文章编号:     中图分类号:    文献标志码:A
基金项目:甘肃省自然科学基金(17JR5RA245)
引用文本:
王媛,聂芳,王引弟,王挺,陈斌娟.剪切波弹性成像技术评估2型糖尿病患者下肢神经病变[J].中国临床研究,2019,32(9):1193-1196.

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