Al-Geffari Metab
College of Medicine, Qassim University.
Int J Health Sci (Qassim). 2012 Jun;6(2):127-34. doi: 10.12816/0005988.
DPN is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of DPN results in fewer foot ulcers and amputations.
The purpose of this study was to compare different screening tests in the detection of DPN in primary care setting.
It is a cross-sectional study in a random sample (N = 242) of type 2 diabetes mellitus participants at primary care setting. Different screening tests for detecting DPN such as Michigan Neuropathy Screening Instrument (MNSI), Semmes-Weinstein Monofilament (SWM), vibration sensation and ankle reflex were performed for each patient and compare between them.
45% of the participant had DPN based on MNSI, The detection rate using the 128-Hz tuning fork and 10-g SWM was nearly same (32.6 & 31.4%) respectively and significantly higher than ankle reflexes (23.1%). Although, the prevalence of DPN determined by the combined two tests (38.79%) was higher than that through the single test.
this study showed different results of DPN screening tests, even in the same group of patients. However there was a significant correlation between them. 128-Hz tuning fork and 10-g SWM monofilament would appear to be an appropriate, cheap and easy to use tool for identifying patients at risk of having neuropathy in primary care setting.
糖尿病周围神经病变(DPN)是糖尿病的一种重要并发症,会增加糖尿病的发病率。有证据表明,早期发现DPN可减少足部溃疡和截肢的发生。
本研究旨在比较在基层医疗环境中检测DPN的不同筛查试验。
这是一项横断面研究,对基层医疗环境中2型糖尿病患者的随机样本(N = 242)进行研究。对每位患者进行了不同的DPN检测筛查试验,如密歇根神经病变筛查工具(MNSI)、Semmes-Weinstein单丝检查(SWM)、振动觉和踝反射,并对这些试验进行比较。
根据MNSI,45%的参与者患有DPN。使用128赫兹音叉和10克SWM的检测率分别接近(32.6%和31.4%),且显著高于踝反射(23.1%)。尽管如此,两项联合试验确定的DPN患病率(38.79%)高于单项试验。
本研究表明,即使在同一组患者中,DPN筛查试验的结果也有所不同。然而,它们之间存在显著相关性。128赫兹音叉和10克SWM单丝似乎是在基层医疗环境中识别有神经病变风险患者的合适、廉价且易于使用的工具。