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投稿时间：2023-06-15 网络发布日期：2023-12-20
投稿时间：2023-06-15 网络发布日期：2023-12-20
中文摘要: 目的 分析在2型糖尿病（T2DM）患者中神经F波传导速度与空腹C肽（FC-P）水平联合检测对糖尿病周围神经病变(DPN)的诊断价值。
方法选择2020年9月至2022年6月在马鞍山市人民医院就诊的30例T2DM合并DPN患者为观察组，30例T2DM未合并DPN患者为对照组，另募集同期健康志愿者30例作为空白组。比较3组血清FC-P、餐后2 h C肽(PC-P)、空腹血糖(FBG)、餐后2 h血糖(PBG)以及糖化血红蛋白(HbA1c)水平。比较3组神经传导速度［包括运动神经传导速度（SCV）和感觉神经传导速度（MCV）］、F波速度。采用二元logistic回归分析T2DM患者发生DPN的危险因素。应用受试者工作特征（ROC）曲线分析各指标对DPN发生的预测价值。
结果 观察组血清FC-P、PC-P水平均低于对照组和空白组，FBG、PBG、HbA1c水平均高于对照组和空白组（P＜0.05）；对照组血清FC-P、PC-P水平均低于空白组，FBG、PBG、HbA1c水平均高于空白组（P＜0.05）。观察组SCV、MCV及F波速度均最慢，对照组次之，空白组最快(P＜0.05)。二元logistic回归分析显示，正中神经F波传导速度慢、FC-P水平低是糖尿病患者发生DPN的危险因素。正中神经F波传导速度（切点为48.05 m/s）联合FC-P（切点为1.61 pmol/L）时对早期诊断糖尿病患者发生DPN的ROC曲线下面积为0.819，敏感度为82.60%，特异度为88.40%。
结论 神经F波传导速度与FC-P水平联合检测能提高对T2DM患者发生DPN的预测价值，可用于早期DPN患者的诊断。
Abstract:Objective To analyze the diagnostic value of combined detection of nerve F-wave conduction velocity(CV) and fasting C-Peptide (FC-P) level in evaluating diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM).
Methods A total of 30 T2DM patients with DPN who were treated at Ma’anshan People's Hospital from September 2020 to June 2022 were selected as the observation group, 30 T2DM patients without DPN were selected as the control group, and 30 healthy volunteers from the same period were recruited as the blank group. The levels of FC-P, 2 h postprandial C peptide (PC-P), fasting blood glucose (FBG), 2 h postprandial blood glucose (PBG) and glycosylated hemoglobin (HbA1c) were compared among the three groups. Nerve conduction velocity (including sensory CV, motor CV) and F-wave CV were compared among the three groups. Binary logistic regression was used to analyze the risk factors of DPN in T2DM patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of various indicators for the occurence of DPN.
Results Compared with control group and blank group, the serum levels of FC-P and PC-P were lower, and the levels of FBG, PBG and HbA1c were higher in the observation group (P＜0.05). The serum levels of FC-P and PC-P in the control group were lower than those in the blank group, and the levels of FBG, PBG and HbA1c in the control group were higher than those in the blank group (P＜0.05). Sensory CV, motor CV and F-wave CV were the slowest in the observation group, followed by the control group, and the fastest in the blank group (P＜0.05). Binary logistic regression analysis showed that slow F-wave CV of median nerve and low FC-P level were the risk factors for DPN in diabetic patients. When median nerve F-wave CV (cut-off point was 48.05 m/s) combined with FC-P (cut-off point was 1.61 pmol/L), the area under ROC of DPN in patients with early diagnosis of diabetes was 0.819, the sensitivity was 82.60% and the specificity was 88.40%.
Conclusion The combined detection of nerve F-wave CV and FC-P level can improve the predictive value of DPN in T2DM patients, and can be used for the diagnosis of early DPN patients.
keywords: F-wave Nerve conduction velocity C-Peptide Type 2 diabetes mellitus Diabetic peripheral neuropathy Motor nerve Sensory nerve Median nerve
文章编号： 中图分类号：R587.2 R747.9 文献标志码：A
基金项目:皖南医学院教学医院科研专项项目（JXYY20200）
附件
| Author Name | Affiliation |
| YOU Ruqin, XU Jing, LI Meiying | Department of Neurology, Ma’anshan People's Hospital, Ma’anshan, Anhui 243000, China |
引用文本：
尤如芹，徐竞，李美英.神经F波传导速度联合空腹C肽检测对糖尿病周围神经病变的早期诊断价值[J].中国临床研究,2023,36(12):1821-1825.
尤如芹，徐竞，李美英.神经F波传导速度联合空腹C肽检测对糖尿病周围神经病变的早期诊断价值[J].中国临床研究,2023,36(12):1821-1825.