赵海燕

[摘要] 目的 探讨高频超声联合肌电图在2型糖尿病患者周围神经病变中的诊断价值。 方法 选取我院2015年5月～2016年6月间收治的2型糖尿病周围神经病变患者38例作为DPN组，抽取同期在我院进行体检的健康人38例作为正常对照组。DPN组与对照组均进行超声检查，同时DPN组进行肌电图检查。 结果 与正常对照组比较，DPN组各神经被膜和束膜肿大增粗，回声减少，神经D1、D2及CSA明显增大，差异具有统计学意义（P<0.05）；DPN组神经CSA指标与肌电图潜伏期正相关，与波幅、传导速度均为负相关，差异有统计学意义（P<0.05）。 结论 高频超声联合肌电图可提高DPN患者的早期诊断率，为患者早期治疗提供最佳治疗时机，值得临床推广使用。

[关键词] 高频超声；肌电图；2型糖尿病围神经病变；临床诊断价值

[中图分类号] R445.1 [文献标识码] A [文章编号] 2095-0616（2017）09-170-04

Value of high frequency ultrasound combined with electromyography in diagnosis of patients with type 2 diabetic peripheral neuropathy

ZHAO Haiyan

B Ultrasound Room， Third People's Hospital of Huizhou， Guangdong， Huizhou 516002， China

[Abstract] Objective To explore the diagnostic value of high frequency ultrasound combined with electromyography in diagnosis of patients with type 2 diabetic peripheral neuropathy （DPN）. Methods 38 patients with type 2 diabetic peripheral neuropathy who were admitted to our hospital from May 2015 to June 2016 were selected as the DPN group. 38 healthy people who received physical examination in our hospital in the same period were selected as the control group. The DPN group and the control group were both given ultrasonography while the DPN group was also given electromyography. Results Compared with the control group， capsule of ganglion and perineurium in the DPN group were enlarged and thickened and the echo was decreased. Nerve D1， nerve D2 and CSA of the DPN group were significantly enlarged. Differences were statistically significant （P<0.05）. In the DPN group， nerve CSA index was positively correlated with incubation period of incubation period， while negatively correlated with amplitude and conduction velocity. Differences were statistically significant （P<0.05）. Conclusion High frequency ultrasound combined with electromyography can improve the early diagnosis rate of DPN patients and provide the best time for early treatment. It is worthy of clinical promotion and application.

[Key words] High frequency ultrasound； Electromyography； Type 2 diabetic peripheral neuropathy； Clinical diagnostic value

糖尿病周圍神经病变（DPN）是糖尿病患者常见的慢性并发症之一，据相关文献统计发病率约为7%～50%[1-2]。其临床表现为感觉和自主神经症状异常，伴发疼痛和痛觉过敏，通常对称性双侧肢体发病，下肢比上肢发病严重，病情进展晚期可损伤运动神经，导致肌力减弱、肌肉萎缩和瘫痪，严重影响患者身体健康和生活质量。DPN患者早期无明显神经损害症状，临床误诊或漏诊率较高[3]。临床上主要通过肌电图来诊断糖尿病周围神经病变，但肌电图不能了解具体病变位置和神经形态、结构的改

变，并且是有创检测，具有一定的局限性。随着超声科技的发展，高频超声已经可以清晰显示神经形态和结构，被广泛应用于神经疾病的诊断中[4]。本文通过观察DPN的超声声像图，与肌电图相关指标对比，来探讨高频超声联合肌电图在2型糖尿病患者周围神经病变中的诊断价值。现报道如下。……