Wang R, Liu X, Guo Y
China-Japan Friendship Hospital, Beijing.
Zhonghua Yi Xue Za Zhi. 1998 Jul;78(7):501-3.
To determine the incidence of radiculopathy in diabetic patients neurophysiologically.
The H-reflexes were elicited by magnetic stimulation to S1 nerve root at the first sacral foramen (S1 H-reflex) in 40 normal subjects and 41 diabetic patients. The action potentials of the H-reflex were recorded from the soleus muscle. For comparison, a popliteal H-reflex (stimulated at popliteal fossa), and a regular distal sensory and motor conduction of the tibial nerves were simultaneously evaluated.
A significant correlation of the peak interval of H wave and M wave (HMI) of the S1 H-reflex with body height and age was confirmed by multiple regression analysis in the normal subjects. The simultaneous regression of the HMI adjusted on age and body height produced the formula as 0.02 x (age) + 0.03 x (height) + 0.92. At 95% normal limits of the significant test, 40.2% HMI and 53.7% amplitude of H waves of the S1 H-reflex, 54.9% latency and 46.3% amplitude of H waves of the popliteal H-reflex, 40.2% SCV and 40.2% amplitude of sensory action potentials were diagnosed as abnormal.
A high incidence rate of diabetic radiculopathy was confirmed to be comparable to that of proximal neuropathy and distal symmetrical sensory polyneuropathy. This suggests that diabetic neuropathy may be related to metabolic and/or vascular disorders.
通过神经生理学方法确定糖尿病患者神经根病的发病率。
对40名正常受试者和41名糖尿病患者在第一骶孔处通过磁刺激S1神经根引出Hoffmann反射(S1 H反射)。从比目鱼肌记录H反射的动作电位。为作比较,同时评估腘窝H反射(在腘窝刺激)以及胫神经常规的远端感觉和运动传导。
在正常受试者中,通过多元回归分析证实S1 H反射的H波和M波的峰间期(HMI)与身高和年龄存在显著相关性。对年龄和身高进行校正后的HMI的同步回归得出公式为0.02×(年龄)+0.03×(身高)+0.92。在显著检验的95%正常限值下,S1 H反射的40.2%的HMI和53.7%的H波振幅、腘窝H反射的54.9%的潜伏期和46.3%的H波振幅、40.2%的感觉神经传导速度和40.2%的感觉动作电位振幅被诊断为异常。
已证实糖尿病神经根病的高发病率与近端神经病变和远端对称性感觉性多神经病的发病率相当。这表明糖尿病性神经病变可能与代谢和/或血管紊乱有关。