Hemmi Shoji, Kurokawa Katsumi, Nagai Taiji, Yokoi Keiichi, Okamoto Toshio, Asano Akio, Murakami Tatsufumi, Mihara Masahito, Sunada Yoshihide
Department of Neurology, Kawasaki Medical School, Japan.
Department of Neurology, Kawasaki Medical School General Medical Center, Japan.
Intern Med. 2020 Aug 15;59(16):1957-1962. doi: 10.2169/internalmedicine.4499-20. Epub 2020 May 23.
Objective To achieve an accurate quantification in diabetic polyneuropathy (DPN), we developed a new electrophysiological index that we called the DPN index. The relationship between the DPN index and the neurological findings in diabetic patients was assessed. Methods The DPN index was calculated by the mean value of percentages of four parameters (tibial compound muscle action potential amplitude / F wave minimum latency, sural sensory nerve action potential amplitude / sensory nerve conduction velocity) against the mean normal values. Twenty healthy subjects were recruited as a control group. Patients A total of 348 diabetic patients who were hospitalized in our hospital during the period from December 2016 to August 2019 were retrospectively studied. The correlations between the DPN index and five neurological findings (subjective sensory symptoms, diminished or absent Achilles tendon reflex, impaired tactile and vibration sense, low coefficient of variation of R-R interval) were evaluated. Results The DPN index in healthy subjects was 129.3±32.7%. The DPN index in diabetic patients with one or more neurological findings was significantly lower than that in diabetic patients without any neurological findings (p<0.01: 89.3±27.8% vs. 118.4±21.2%). For each of the five neurological findings, the DPN index in the group with an abnormality was significantly lower than that in the group without any abnormality (each p<0.01). Spearman's correlation coefficients indicated that a greater number of neurological findings resulted in a lower DPN index (r=-0.711, p<0.01). Conclusion Our study suggested that the DPN index is useful for evaluating the severity of DPN.
目的 为了在糖尿病性多发性神经病（DPN）中实现准确量化，我们开发了一种新的电生理指标，即DPN指数。评估了DPN指数与糖尿病患者神经学表现之间的关系。方法 DPN指数通过四个参数（胫神经复合肌肉动作电位幅度/F波最小潜伏期、腓肠感觉神经动作电位幅度/感觉神经传导速度）相对于正常平均值的百分比的平均值来计算。招募了20名健康受试者作为对照组。患者 对2016年12月至2019年8月期间在我院住院的348例糖尿病患者进行回顾性研究。评估了DPN指数与五项神经学表现（主观感觉症状、跟腱反射减弱或消失、触觉和振动觉受损、R-R间期变异系数低）之间的相关性。结果 健康受试者的DPN指数为129.3±32.7%。有一项或多项神经学表现的糖尿病患者的DPN指数显著低于无任何神经学表现的糖尿病患者（p<0.01：89.3±27.8%对118.4±21.2%）。对于五项神经学表现中的每一项，异常组的DPN指数均显著低于无任何异常的组（每项p<0.01）。Spearman相关系数表明，神经学表现数量越多，DPN指数越低（r=-0.711，p<0.01）。结论 我们的研究表明，DPN指数有助于评估DPN的严重程度。
