Evaluation Of The Clinical Value Of Diabetic Peripheral Neuropathy Screening Process

[Objective]To evaluate clinical values of diabetic peripheral neuropathy(DPN)screening process in the diagnosis of DPN,we compare it with the Neural electrophysiological test(NET)and the Toronto clinical scoring system(TCSS),so as to find accurate,economical and convenient method for the screening of DPN.[Methods]113 patients with type 2 diabetes who were admitted to the Department of Endocrinology of Sir Run Run Shaw Hospital affiliated to Zhejiang University Medical College from May to August 2015,and were given diabetic neuropathy screening process,NET and TCSS,respectively.The patients were divided into non-DPN group and DPN group based on results of NET to analyze sensitivity,specificity,positive predictive value,negative predictive value,Youden’s index and kappa index of DPN screening process and TCSS scoring system in the diagnosis of DPN.In addition,Receiver Operating Characteristic Curve(ROC)of DPN screening process and TCSS scoring system was made to calculate AUC,and compare between DPN screening process and TCSS scoring system in diagnostic values.The severity of DPN screening process was graded,and the correlation between the severity of DPN and the incidence of other diabetic complications was discussed.Related clinical parameters and NET were adopted to perform single factor logistic regression analysis and multivariate logistic stepwise regression analysis to discuss the risk factors of DPN.[Results]The positive rate of DPN screening process was higher than that of TCSS,the sensitivity,specificity,positive predictive value,negative predictive value,Youden’s index and kappa index of DPN screening process were 76.9%,68.7%,76.9%,68.7%,0.456 and0.457;and the sensitivity,specificity,positive predictive value,negative predictive value,Youden’s index and kappa index of TCSS scoring system were 56.9%,85.4%,84.1%,59.4%,0.423 and0.400.DPN screening process had higher Youden’s index,suggesting that DPN screening process was accurate in the diagnosis of nervous diseases.DPN screening process had higher Kappa index,the consistency of NET was better.ROC curve area of DPN screening process and TCSS scoring system in the diagnosis of DPN was 0.743 and 0.740,being of no significant difference(P>0.05)with similar diagnostic value.With the increase of the severity of DPN,the incidence of diabetic complications gradually increased,DPN and other diabetic complications are closely related.Course of disease was found to be the risk factor of DPN by single factor Logistic regression analysis and multivariate Logistic stepwise regression analysis.[Conclusion]DPN screening process and TCSS scoring system have high sensitivity and specificity,but compared with TCSS scoring system,DPN screening process has higher diagnostic values and reliability,more suitable for screening of outpatients and epidemiological survey.DPN screening is simpler,faster,more economical than NET,and is easier to be accepted by patients.