摘要
目的分析密歇根神经筛查量表(MNSI)、痛觉触觉温觉检测联合震动感觉阈值(VPT)对糖尿病周围神经病变(DPN)的诊断价值。方法回顾性选取2018年1—12月在上海交通大学医学院附属新华医院崇明分院住院治疗的2型糖尿病(T2DM)患者500例,其中64例DPN患者纳入DPN组,其余436例纳入非DPN组。比较两组临床资料及MNSI、痛觉触觉温觉检测阈值及VPT检测结果,绘制受试者工作特征(ROC)曲线分析上述检查指标单一及联合诊断DPN的临床价值。结果DPN组MNSI症状问卷评分及MNSI体格检查评分均高于非DPN组[(3.00±1.35)分比(1.69±0.52)分、(1.57±0.50)分比(1.01±0.24)分],触觉、痛觉、温觉减退或消失比例高于非DPN组,且DPN组VPT高于非DPN组[(26.34±5.03)V比(17.97±6.82)V],差异均有统计学意义(P<0.01);单一指标诊断时VPT诊断的曲线下面积(AUC)值最高为0.825,并显著高于触觉、痛觉、温觉(P<0.01);联合诊断时VPT+MNSI的AUC值最高为0.738,诊断DPN的灵敏度、特异度为51.56%、96.10%。结论VPT诊断DPN效能最佳,联合MNSI可进一步提升特异度,但灵敏度下降,值得临床重视。
Objective To analyze the diagnostic value of Michigan nerve screening Scale(MNSI),pain,touch and temperature detection combined with vibratory perception threshold(VPT)in diabetic peripheral neuropathy(DPN).Methods A total of 500 patients with type 2 diabetes mellitus(T2DM)who received inpatient treatment in Xinhua Hospital Chongming Branch Affiliated of Shanghai Jiao Tong University School of Medicine from January to December 2018 were selected.Sixty four patients with DPN were enrolled in the DPN group,and the remaining 436 patients were enrolled in the no-DPN group.The clinical data and the results of MNSI scale,pain,touch and temperature detection thresholds and VPT of the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the clinical value of single and combined examination indicators in the diagnosis of DPN.Results MNSI symptom questionnaire score and MNSI physical examination score in DPN group were higher than those in no-DPN group:(3.00±1.35)scores vs.(1.69±0.52)scores,(1.57±0.50)scores vs.(1.01±0.24)scores;the proportion of touch regression,pain regression and temperature regression was significantly higher than that in no-DPN group;and the levels of VPT in the DPN group was higher than that in the no-DPN group:(26.34±5.03)V vs.(17.97±6.82)V,there were statistical differences(P<0.01).When the single index was diagnosed,the area under the curve(AUC)value of VPT was the highest(0.825),and significantly higher than the pain,touch and temperature detection(P<0.01).The AUC value of VPT+MNSI in combined diagnosis was the highest(0.738),and the sensitivity and specificity of DPN diagnosis were 51.56%and 96.10%,respectively.Conclusions Compared with MNSI scale score,sensory detection such as pain,touch and temperature,VPT has the best diagnostic efficiency for DPN,while combined with MNSI,the specificity can be further improved,but the sensitivity decreases,which is worthy of clinical attention.
作者
杨婕
邢寅
石群
Yang Jie;Xing Yin;Shi Qun(Department of Endocrinology,Xinhua Hospital Chongming Branch Affiliated of Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China)
出处
《中国医师进修杂志》
2023年第8期727-730,共4页
Chinese Journal of Postgraduates of Medicine
关键词
糖尿病
2型
糖尿病神经病变
密歇根神经筛查量表
震动感觉阈值
Diabetes mellitus,type 2
Diabetic neuropathies
Michigan neurological screening scale
Vibratory perception threshold
作者简介
通信作者:石群,Email:shiqun10@yeah.net。
