| Objective: Diabetes peripheral neuropathy (DPN) is a common complication of diabetes mellitus(DM),and has a high incidence rate. All of peripheral nerves,including vegetative nerves,can be affected. The impairments often take place early,even in latent diabetes mellitus.The pathogenesis of DPN is still not very clear,and the clinical manifestations are various.The symptoms and signs often appear later than pathological changes,so that the latter often have been very obvious when the diagnosis is definite.And the chance of therapy in early state has been lost,then the prognosis will be affected.Currently,the diagnosis of DPN is mainly depending on the history of DM,the symptoms and signs of impairments on nervous system,and the abnormalities of electrophysiology. Many civil and foreign scholars have studied the electrophysiological manifestation of DPN.Nerve conductive velocity (NCV) and distal motor latency(DML) can respond characteristics of demyelination. The decrease of motor or sensory action potential can respond axonal degeneration, andsomatosensory evoked potential(SEP) can supply information of sensory nerve fiber's proximal segments.Single fiber electromyography(SFEMG) can evaluate the function of nerves and muscles objectively and quantitatively. F wave is produced by the stimulation of motor fibers that travel antidromically to the anterior horn cells,a small number of anterior horn cells are activated and produce an orthodromic response that can recorded in a distal muscle.The examination of F wave has very important clinical values to estimate the whole motor nerve's function, especially the proximal segments, and the nature of peripheral neuropathy.It can also help us observe how the functions of nerve has recovered.Now the researches on F wave of DPN are few and are mainly confined to F latency minimum(Flmi).However,the researches on F wave conduction velocity(Fwcv),F chrondispersion(Fchd),and F ratio are much less.The objective of this research is to evaluate the diagnostic value of F wave in DPN by investigating F wave between diabetes mellitus and healthy subjects,and the relationship between the abnormalities of F wave and clinical manifestation of DM,so as to decide diagnosis and start treatment early,then prognosis should be improved.Methods: F wave of the median and tibial nerves were measured in 91 patients with diabetes mellitus(All comformed to diagnostic standard for type 2 DM pulicized by WHO in 1999,and none of them had impairments on nerves and muscles caused by other factors) and 48 healthy persons(None had history of DM or impairments on nerves and muscles) with type Cantata electromyography machine of Dantec company in Denmark . Flmi, Fchd, Fwcv and F ratio were analyzed.Motor nerve conductive velocity(MCV) and sensory nerve cinductive velocity(SCV) of median,ulnar,tibial,common peroneal and sural nerves were also measured, and diatal latency, conductive velocity and amplitude were analyzed. FBG and GHBA1C of all patients were measured on first day after the patients had been in hospital. The duration were recorded. The patients were divided into two groups,DPN group(64 cases) and DM group without peripheral neuropathy(27 cases),according to clinical manifestations and the results of routine nerve conduction techniques.Dealing with the datum with SAS statistic software. Results: 1. In the 64 patients with DPN, Flmi, Fchd, Fwcv and F ratio of median and tibial nerves were significantly different with contol group(P<0.05). 2. The abnormality rates of all F wave parameters were high,respectively, Flmi(67.2%), Fchd(59.4%), Fwcv(64.1%), F ratio(37.5%). 3. The total abnormality rate of F wave of median and tibial nerves in DPN group was 76.6%,while MCV was 59.4%,the difference beteen them is significant(P<0.05). 4. In DM group without peripheral neuropathy,the abnormality rates of F wave parameters were,respectively, Flmi(14.8%),Fchd(25.9%),Fwcv(14.3%),F ratio(3.7%). 5. The relationship between the abnormality rat... |
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