·糖尿病神经病变·

　　【摘要】 目的 探讨感觉电流阈值(CPT)评估T2DM患者感觉神经纤维损伤的价值。 方法 选取T2DM患者218例，根据有无神经系统症状，分为有症状组和无症状组，各109例。采用感觉神经定量检测仪对感觉神经纤维功能进行2000 Hz、250 Hz、5 Hz 3种不同强度的客观测试，比较不同部位不同强度刺激下的CPT。 结果 有症状组CPT异常者多于无症状组[96(88.1%) vs 51(46.8%)，P<0.01];两组不同部位不同强度的CPT比较，差异有统计学意义(P<0.05);有症状组中，有麻木症状(麻木亚组)者40.4%，有刺痛症状(刺痛亚组)者13.8%，既有麻木又有刺痛症状(麻木+刺痛亚组)者43.1%。麻木亚组主要以2000 Hz损伤为主，刺痛亚组、麻木+刺痛亚组主要以2000 Hz和250 Hz损伤为主。 结论 糖尿病患者有神经系统症状时，不同强度刺激下粗有髓鞘神经纤维(Aβ)、细有髓鞘神经纤维(Aδ)和无髓鞘神经纤维均受损，以Aβ和Aδ纤维损伤最为明显。

　　【关键词】 糖尿病，2型;神经纤维;感觉电流阈值

　　The application of current perception threshold in evaluating the diabetic nerve fiber damage ZHAO Ren-hua，NIU Ben，SU Heng，et al.Department of Endocrinology，The First People’s Hospital of Yunnan Province，Kunming 650032，China

　　Corresponding author：NIU Ben，E-mail：921638630@qq.com

　　【Abstract】 Objective To investigate the value of current perception threshold(CPT)in evaluating the diabetic sensory nerve fiber damage. Methods 218 patients with type 2 diabetes (T2DM)were divided into two groups named symptomatic group (n=109) and asymptomatic group (n=109). Quantitative sensory nerve detector was used to test the CPT of different parts of the body at different degrees of stimulation (2000 Hz，250 Hz and 5 Hz). Results The proportion with abnormal CPT in symptomatic group (88.1%) was higher than that in asymptomatic group (46.8%) (P<0.01). The CPT of different parts at various degrees of stimulation between two groups had significant difference (P<0.05). In symptomatic group，40.4% presented with numbness (numbness subgroup)，13.8% with tingling (tingling subgroup)，and 43.1% with both numbness and tingling symptoms (numbness + tingling subgroup). Damage of sensory nerve fiber in numbness subgroup mainly occurred at 2000 Hz，and in tingling subgroup and numbness + tingling subgroup at 2000 Hz and 250 Hz. Conclusion The CPT of different degrees of stimulation showed that the coarse，fine and nonmyelinated nerve fibers were all damaged in T2DM patients with neurological symptoms，especially in Aβ and Aδ nerve fibers.

　　【Key words】 Diabetes mellitus，type 2;Nerve fibers;Current perception threshold(CPT)