【摘要】 目的 分析神经传导检查在糖尿病周围神经病变(DPN)中的特点，提高用神经传导检查方法诊断DPN的敏感性。方法 对符合标准的213例患者的2283条神经行传统的神经传导、F波、H反射检查，并分析各条神经总的神经电生理检查情况。结果 2283条神经进行常规神经传导检查结果显示，感觉神经传导速度(SCV)中正中神经的异常率最高，运动神经传导速度(MCV)中胫神经、正中神经异常率高，最长的胫神经运动神经神经传导异常率为47.45%，容易合并卡压的正中神经感觉神经传导异常率为46.83%，而腓肠神经感觉神经传导异常率最低(22.60%)。对有临床明确症状的21条神经进行神经传导检查，异常率可达76.19%。对感觉神经传导异常的尺神经进行运动神经传导检查，尺神经异常率57.14%。常规神经传导检查，正中神经感觉神经传导异常率(46.83%)高于正中神经运动神经传导异常率(41.13%)。正中神经感觉神经传导异常者作运动神经传导异常率为76.56%，正中神经运动神经传导异常者感觉神经传导异常率为89.63%。尺神经F波、胫神经H反射的异常率分别为25.83%、52.24%。结论 DPN具有长度依赖性、与临床表现一致、感觉重于运动、全长弥漫受累等特点，根据这些特点选择神经进行神经传导检查，可提高神经传导检查诊断DPN的敏感性。

　　【关键词】 糖尿病,2型;糖尿病神经病变; 神经传导检查; F波; H反射

　　【Abstract】Objective To improve the sensitivity for the diagnosis of type 2 diabetic neuropathy with nerve conduction study by analyzing the characteristics of the type 2 diabetic neuropathy. Methods Nerve conduction, F wave, H reflex studies were performed in 2626 nerves of 213 patients meeting a criterion. Results Nerve conduction studies(NCS) were performed in 2283 nerves. The abnormal rate of median nerve was highest in sensory nerve conduction (SNC), and the top abnormal rate of motor nerve conduction (MNC) was tibial and median nerve. The rate of abnormal motor nerve conduction of tibial nerve ,as the longest，is 47.45%，then is median nerve ,which is vulnerable to pressure, 46.83%.The lowest abnormal sensory nerve conduction rate of sural nerve is 41.31%.16 nerves in 21 with definite clinical features were abnormal. Cubital nerve with abnormal sensory nerve conduction underwent motor nerve conduction study. 57.14% of them were abnormal. The abnormal rate of sensory nerve conduction of median nerve(46.83%) is higher than that of motor nerve conduction(41.31%). 76.56% of motor nerve conduction of median nerve with abnormal sensory nerve conduction is abnormal. 89.63% of sensory nerve conduction of median nerve with abnormal motor nerve conduction was abnormal. F wave of cubital nerve, H reflex of nerves tibialis were performed. 25.83%, 52.24% of them were abnormal. Conclusion Type 2 diabetic peripheral neuropathy is length-dependent,accordant with clinical manifestation. Sensory nerve is more vulnerable. Choosing nerves and performing NCS according to these characteristics can improve the sensitivity for the diagnosis of type 2 diabetic peripheral neuropathy with nerve conduction study.

　　【Key word】 Diabetic peripheral neuropathy; nerve conduction study; F wave; H reflex