| Objectives:In this study,we use nerve conduction studies(NCS),F-wave,skin sympathetic response(SSR)to evaluate the characteristics of peripheral neuropathy in patients with impaired glucose regulation(IGR),to compared with neurological impairment in patients with diabetes mellitus(DM)and to explore the diagnostic value of neuroelectrophysiological examination for neuropathy associated with prediabetes(NAP).Methods:A total of 100 inpatients in the Department of Neurology of 2nd people's hospital of Yunnan province from January 2017 to February 2018 were selected,including 50 patients with IGR and 50 patients with DM.Another 50 healthy volunteers were included in the control group.All subjects were examined by NCS,F-wave and SSR with the KEYPOINT 4ch electromyography/evoked potential meter produced by Dantec of Denmark for medianus,ulnaris,tibialis,peroneus.Medianus,ulnaris,tibialis were added to evaluate the proximal nerve function by F-wave.NCS detection parameters include compound motor active potential(CMAP),distal motor latency(DML),sensory nerve active potential(SNAP),sensory nerve conduction velocity(SCV),motor nerve conduction velocity(MCV).The F-wave detection parameters include the F-wave occurrence rate,F-wave latency minimum(Flmin),F-wave latency maximum(Flmax),F-wave latency mean(Flmean),F-wave chronodispersion(Fchd).SSR detection parameters include SSR latency and SSR amplitude of upper and lower limb.Results:1.Comparison of NCS between IGR group and control group:There were no significant differences in DML,CMAP,SNAP,SCV and MCV between medianus,ulnaris,tibialis and peroneus(P>0.05).Comparison of F-wave detection results:There was no significant difference in F-wave occurrence rate,Flmean and Fchd between medianus,ulnaris and tibialis(P>0.05).Comparison of SSR results:There was no significant difference in SSR latency between the upper and lower limbs(P>0.05),and the significant difference in SSR amplitude of lower limbs(P<0.05).2.Comparison of NCS results between IGR group and DM group:There was significant difference in SNAP between tibialis and peroneus(P<0.05).Comparison of F-wave detection results:Flmean was differents between medianus,ulnaris and tibialis were significant differences(P<0.05).Comparison of SSR results:There were no significant differences in SSR latency and amplitude between upper and lower limbs(P>0.05).3.The amplitude of SSR of the lower limbs of IGR patients was significantly different from the normal control group by SSR(P<0.05),while the other items showed no abnormalities.4.To analyze the correlation of age,body mass index(BMI),fasting plasma glucose(FPG),glycated hemoglobin(HbAlc),triglyceride(TG),total cholesterol(TC),systolic blood pressure(SBP)and diastolic blood pressure(DBP)between peripheral nerve damage.The results showed that the correlation coefficients of FPG,HbA1c and BMI with SNAP,SCV and SSR of tibialis and peroneus are P<0.01.5.Comparison of the latency and amplitude of SSR,NCS and F-wave of tibialis between peroneus of lower limbs.The Yoden index from high to low is combined detection,SSR amplitude of lower limbs,SSR latency of lower limbs,SNAP of tibialis.The remaining indicators of the Yoden Index are too low.Conclusions:1.IGR patients have peripheral nerve damage,and the lower limbs are mainly caused by small fiber damage.2.Peripheral nerve damage in DM patients involves large and small fibers,and the upper and lower limbs can be affected.3.Compared with DM group and IGR group,both of it had small fiber damage,and the degree of small fiber damage was significantly heavier than IGR patients.4.There is a medium intensity correlation between fasting blood glucose,HbAlc and BMI and sensory neuropathy of lower limbs,suggesting that blood glucose levels and obesity may play an important role in peripheral neuropathy.5.The amplitude of SSR of lower limbs in the single electrophysiological index is the most effective in the diagnosis of NAP.6.Combined SSR,NCS and F-wave can significantly improve the diagnostic performance of NAP. |
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