·糖尿病与神经疾病·

　　【摘要】 目的 评价多伦多临床评分系统(TCSS)及其神经病变分级在糖尿病周围神经病变(DPN)中的应用价值。 方法 对120例T2DM患者进行TCSS检查，根据神经电生理检查结果分为DPN组与非DPN组，与TCSS≥6分的结果进行比较，确定TCSS诊断DPN的合适截断点。 结果 TCSS≥6分的诊断正确率、灵敏性、特异性分别为72.5%，72.4%，72.7%，对应的约登指数及Kappa值分别为0.45及0.51，受试者工作特性曲线(ROC)下面积0.817。TCSS≥6分与神经电生理检查的一致性较好;该评分合适的截断点为6分。 结论 TCSS是一种相对快速、安全、简单、可靠的DPN筛查方法，对DPN的严重程度分级及评价有一定的临床应用价值。

　　【关键词】 多伦多临床评分系统;糖尿病，2型;糖尿病神经病变

Application of Toronto clinical scoring system screening diabetic peripheral neuropathy in T2DM patients LOU Da-jun, ZHU Qi-qian, SI Xu-wei. Department of Endocrinology and Metabolism, Shaoxing People’s Hospital, Shaoxing 312000, China

Corresponding author: ZHU Qi-qian, E-mail: sxzqq@126.com

　　【Abstract】Objective To evaluate the application value of Toronto clinical scoring system (TCSS) and its grading of neuropathy for diabetic peripheral neuropathy (DPN). Methods In this study, 120 T2DM patients received TCSS assessment. Taking electrophysiological examination as a gold standard for diagnosing DPN, the results of TCSS score ≥ 6 and electrophysiological examination were compared to confirm the optimal cut off points of TCSS. Results The corresponding accuracy, sensitivity, and specificity of TCSS score ≥ 6 were 72.5%, 72.4%, and 72.7% respectively. The Youden index and Kappa were 0.45 and 0.51 respectively，revealing that TCSS score≥ 6 had a moderate consistency with electrophysiological examination. The area under the ROC curve of TCSS was 0.817. The optimal cut off point of TCSS was 6. Conclusion TCSS can be used as a relatively simple and reliable method for screening and assessment of DPN and its grading of neuropathy has clinical value.

　　【Key words】 Toronto clinical scoring system; Diabetic peripheral neuropathy; Diabetes mellitus, type 2;