Correlations of neurophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy / 中华全科医师杂志

ABSTRACT

Objective To explore the correlation of electrophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy (DPN).Methods The clinical data of 306 patients with DPN undergoing nerve conduction study (NCS) during May 2013 to June 2015 were retrospectively analyzed.Among 306 patients,304 were type 2,and 2 were type 1 diabetes with a mean age of 64.1 years and disease duration of 1 week-31 years.The relationship between the electrophysiological features and clinical manifestations was evaluated.Nerve conduction studies and F-wave and in sympathetic skin response were analyzed.Results ① NCS in lower limbs presented more abnormalities than that in upper limbs.There was the highest prevalence of not elicited sensory potential in Tibial nerve [56.9％(174/306),x2 =175.9] and the highest prevalence of not elicited motor potential in peroneal nerve [7.8％(24/306),x2 =1 103.1].Amplitude abnormality was more severe in sensory nerve than that in motor nerve[41.4％ (507/1 224) vs.10.8％ (132/1 224),x2 =559.2].The ratio of abnormal motor conduction velocity or distal latency was higher than that of amplitude decreased [22.9％ (280/1 224) vs.10.8％(132/1 224),x2 =1 077.4].② The abnormal ratios of the shortest F-wave latency was lower than that of the prolonged distal latency in median and tibial nerve [5.4％ (33/612) vs.20.6％ (126/612),x2 =607.6].③ The abnormal ratio of sympathetic skin response (SSR) in lower limbs were higher than that of upper limbs [40.2％ (246/612) vs.27.3％ (167/612),x2 =129.4,P ＜ 0.001],abnormal ratio of amplitude was higher than that of the prolonged latency [30.1％ (368/1 224) vs.4.7％ (58/1224),x2 =1040.5,P ＜0.001].Among the 99 cases presenting abnormal SSR in upper limbs,32 cases were normal in conventional NCS.Among the 127 cases presenting abnormal SSR in lower limbs,7 cases were normal in conventional NCS.④Disease course and glycosylated hemoglobin values were positively correlated with the distal motor latency,and negatively correlated with the nerve conduction velocity and amplitude.Conclusion Electrophysiological features of DPN is mainly shown in axon of the distal sensory nerve.Long duration and hyperglycemia may lead to more abnormalities in electrophysiological tests.