糖尿病患者H反射与神经传导速度检测结果的临床分析

目的探讨H反射、运动神经传导速度（MCV）、感觉神经传导速度（SCV）检测方法,对糖尿病患者周围神经元近端损害情况临床诊断价值。方法采用Keypoint 4.0型肌电图仪,测定50例患者的正中神经、尺神经、腓总神经的MCV,正中神经、尺神经、腓浅神经的SCV及胫神经H反射。结果50例患者中,H反射异常33例、异常率66%,MCV异常12例、异常率24%,SCV异常21例、异常率42%。以H反射、SCV异常为主。在病程〈5年的19例中,H反射异常12例、占63%,SCV异常10例、占52.6%;病程〉5年的31例中,H反射异常21例、占68%,SCV异常18例、占58%。结论H反射检测对临床上早期诊断糖尿病周围神经病变有较大帮助,提示在进行糖尿病患者的神经电生理检查时,H反射应作为常规检测项目。

Clinical Analysis of the Results of H-reflex Detection and of Nerve Conducting Velocity Detection of the Patients with Diabetes Mellitus

Objective To discuss the clinical diagnosing value of the detection of H-reflex,motor nerve conduction velocity(MCV) and sensory nerve conduction velocity(SCV) in observing the injuries of peripheral neuronal proximates.Methods The detection of the MCV of median nerve,ulnar nerve and common peroneal nerve,the SCV of median nerve,ulnar nerve and superficial peroneal nerve,and the H-reflex of tibial nerve was made to 50 cases with diabetes mellitus with Electromyography Apparatus Keypoint 4.0.Results Out of the 50 cases,abnormal Hreflex was found in 33 cases,the abnormal rate was 66%;abnormal MCV was found in 12 cases,the abnormal rate was 24%;abnormal SCV was found in 21 cases,the abnormal rate was 42%;out of the 19 cases with the pathogenesis below 5 years,12 cases showed abnormal H-reflex(63%) and 10 cases had abnormal SCV(52.6%); out of the 31 cases with the pathogenesis over 5 years,21 cases showed abnormal H-reflex(68%) and 18 cases showed abnormal SCV(58%).Conclusions The detection of H-reflex is of great help in the early diagnosis of diabetic peripheral neuropathy and should be the routine item in the nerve electrophysiological examination of the patients with diabetes mellitus.