The Comparative Study Of Different Nerve Fiber Types Damage By Current Perception Threshold In Diabetic Patients

Objective Type2diabetic peripheral neuropathy may have small nerve fibers and (or)large nerve fibers involved, but Aδ small myelinated nerve fibers and C non-myelinatednerve fibers are damaged more common than Aβ large myelinated nerve fibers, theNeurometerCPT/C nerve measuring detector can reflecting the small nerve fiber function,this study investigate the clinical value of current perception threshold(CPT) examinationin non-diabetic peripheral neuropathy in type2diabetes mellitus(DM) patients,detect thesensory nerve, and analyses nerve fiber damage situation under different parameters.Methods The study included76patients with a diagnosis of type2diabetes mellitus(T2DM), by current perception threshold (CPT) for bilateral median nerve, sural nerve in2000Hz,250Hz,5Hz current, analysis of patients with normal or hyperesthesia orhypoesthesia, analyze the positive rate and the relationship between frequencies. Detailedand various clinical indicators of diabetes were recorded, and analyze the relations betweenCPT and course of disease, glycosylated hemoglobin and fasting blood sugar.Result The nerve abnormalities are mainly for hyperesthesia and hypoesthesia, theleft median nerve at2000Hz current positive rate is27.6%, at250Hz current positive rateis48.7%,and at5Hz current positive rate is34.2%, the right median nerve at2000Hzcurrent positive rate is32.9%, at250Hz current positive rate is55.3%, and at5Hz currentpositive rate is40.8%, the left sural nerve at2000Hz current positive rate is36.8%, at250Hz current positive rate is55.3%,and at5Hz current positive rate is38.2%,the rightsural nerve at2000Hz current positive rate is46.1%, at250Hz current positive rate is65.8%,and at5Hz current positive rate is47.4%, of which the same side median nerve andsural nerve at the same frequency CPT compared with the other side have statisticalsignificance difference (P <0.05), the bilateral median nerve and the sural nerve at thesame frequency CPT contrast have no significant difference (P>0.05), and a nerve in thethree current frequency CPT contrast in the bilateral median nerve and the sural nerve,the 250Hz current nerve sensitivity is sensitive than the5Hz current nerve sensitivity,and theyare sensitive than2000Hz current nerve sensitivity,they all have significant differences(P<0.05). The longer of the course, the higher of the CPT, there are statistically significantdifference(P<0.05); compared with normal group of glycosylated, the abnormal group CPTis significantly higher, which has statistically significant difference(P<0.05); comparedwith normal group of fasting blood sugar, the abnormal CTP group is significantly higher,which has statistically significant difference(P<0.05).Conclusion This study proved that the diabetic peripheral neuropathy are mainlysymmetrical damage, and the lower extremilies are damaged more serious than upperextremilies，and the non-myelinated and small myelinated nerve fibers are damaged moreserious than large myelinated nerve fibers, The course of disease and hyperglycaemia arethe dangerous and important factors for diabetic peripheral neuropathy (DPN) and nervouslesion. This detection method offers a new method for diabetic peripheral neuropathy smallfiber nerve damage, is a new objective and quantitative evaluation way for peripheralnerves detection, makes up the deficiencies of traditional inspection technology, and havepotential clinical application. It also can be used as a treatment and prognosis of objectiveindicators, which makes early diagnosis and monitoring of treatment outcomes in diabetesperipheral neuropathy and lesion evolution conditions possible.