Perkins Bruce A, Grewal Jaspreet, Ng Eduardo, Ngo Mylan, Bril Vera
Toronto General Hospital, 200 Elizabeth St., Room EN-12-217, Toronto, Ontario, Canada M5G 2C4.
Diabetes Care. 2006 Sep;29(9):2023-7. doi: 10.2337/dc08-0500.
The diagnosis of diabetic sensorimotor polyneuropathy using objective electrophysiological tests is hindered by limited access to the specialized laboratories and technicians that perform and interpret them. We evaluated the performance characteristics of a novel portable and automated point-of-care nerve conduction study device, which can be operated by nontechnical personnel, and compared it with conventional nerve conduction studies performed in a specialist setting.
Seventy-two consecutive patients with diabetes (8 type 1, 64 type 2) from a diabetes and a neuropathy outpatient clinic were evaluated concurrently with conventional nerve conduction studies (the reference standard) and the point-of-care device for sural nerve function (sural nerve amplitude potentials in microvolts [microV]).
Sural nerve amplitude potentials measured by the point-of-care device shared very strong correlation with the reference standard (Spearman's correlation coefficient 0.95, P < 0.001). The Bland and Altman method yielded agreement despite a small systematic underestimation by the point-of-care device of 1.2 +/- 3.4 microV. Despite this small systematic bias, the sensitivity and specificity of normal and abnormal sural nerve amplitude potentials measured by the point-of-care device for the detection of diabetic sensorimotor polyneuropathy defined by standard clinical and electrophysiological criteria were 92 and 82%, respectively.
A novel point-of-care device has excellent diagnostic accuracy for detecting electrophysiological abnormality in the sural nerve of patients who have diabetes. This automated device represents an alternative to conventional nerve conduction studies for the diagnosis of diabetic sensorimotor polyneuropathy.
使用客观电生理测试诊断糖尿病感觉运动性多发性神经病受到限制，因为能够进行并解读这些测试的专业实验室和技术人员有限。我们评估了一种新型便携式自动即时护理神经传导研究设备的性能特征，该设备可由非技术人员操作，并将其与在专业环境中进行的传统神经传导研究进行比较。
来自糖尿病和神经病门诊的72例连续糖尿病患者（1型8例，2型64例）同时接受了传统神经传导研究（参考标准）和用于腓肠神经功能的即时护理设备评估（以微伏[μV]为单位的腓肠神经振幅电位）。
即时护理设备测量的腓肠神经振幅电位与参考标准具有非常强的相关性（斯皮尔曼相关系数0.95，P<0.001）。尽管即时护理设备存在1.2±3.4μV的小系统低估，但Bland和Altman方法仍得出了一致性结果。尽管存在这种小的系统偏差，但即时护理设备测量的正常和异常腓肠神经振幅电位用于检测由标准临床和电生理标准定义的糖尿病感觉运动性多发性神经病的敏感性和特异性分别为92%和82%。
一种新型即时护理设备在检测糖尿病患者腓肠神经电生理异常方面具有出色的诊断准确性。这种自动化设备代表了用于诊断糖尿病感觉运动性多发性神经病的传统神经传导研究的替代方法。
