目的探讨2型糖尿病患者经皮氧分压(TcPO2)与神经传导功能测定(NCS)结果的相关性。方法收集第三军医大学西南医院2012年1-7月年龄匹配的2型糖尿病住院患者381例,根据NCS是否异常以及有无糖尿病周围神经病变(DPN)症状分为4组:1组(有NCS异常,无DPN症状)129例、2组(无NCS异常,有DPN症状)50例、3组(有NCS异常,有DPN症状)122例、4组(无NCS异常,无DPN症状)80例,其中1、3组为DPN组,2组为疑似DPN组,4组为无DPN组。分析TcPO2立位、卧位、立卧位差值等33项指标的组间差异以及TcPO2与NCS各参数的相关性。结果与无DPN组比较,DPN组、疑似DPN组TcPO2立位、卧位值降低,立卧位差值增高(P〈0.05)。TcPO2立位值与NCS的正中神经运动传导速度、远端潜伏期、复合肌肉动作电位波幅等26项参数均相关(P〈0.05),TcPO2卧位值与除F波最短潜伏期以外的25项参数相关,TcPO2立卧位差值则与其中11项参数相关(P〈0.05)。结论 TcPO2与NCS有很好的相关性,有望成为DPN的有效检测手段。
Objectives To investigate the correlation between transcutaneous oxygen partial pressure(TcPO2) and nerve conduction determination(NC) in type 2 diabetic patients.Methods From January to July in 2012,381 age-matched type 2 diabetic patients were enrolled in the Xi'nan Hospital of Third Military Medical University.These patients were divided into 4 groups depending on the results of NCS and symptoms of diabetic peripheral neuropathy(DPN),among which there were 129 with abnormal NCS but no DPN symptoms as group 1,50 with DPN symptoms and normal NCS as group 2,122 with both abnormal NCS and DPN symptoms as group 3 and 80 without abnormal NCS nor any DPN symptoms as group 4.Groups 1 and 3 served as DPN group,while groups 2 and 4 were respectively named as possible DPN group and non-DPN group.The differences of 33 indexes of TcPO2 in erect and recumbent positions,correlation between TcPO2 values and differences in erect and recumbent positions between groups,and the correlation between TcPO2 values and various NCS parameters were analyzed.Results The values of TcPO2 in erect position and recumbent position in DPN and possible DPN group were lower,while the difference between them was higher than that(erect-recumbent position difference) in non-DPN group(P〈0.05).The value of erect position TcPO2 was correlated with all the 26 parameters of NCS including the velocity of median nerve conduction,distal latency,amplitude of compound muscle action potential(P〈0.05);the value of recumbent position TcPO2 was also correlated with almost all parameters except the shortest latency of F wave;the erect-recumbent position difference was correlated with 11 out of the above 26 parameters(P〈0.05).Conclusion There is a good correlation between TcPO2 and NCS,which suggests that TcPO2 can serve as a potential and effective method for detecting DPN at early stage.