【摘要】目的  应用Neurometer®CPT/C神经测量仪检测临床确诊T1DM患者周围神经的电流感觉阈值（CPT），对比分析大小纤维受损的程度，从而为糖尿病周围神经病变（DPN）早期诊断提供有效证据。  方法  测定52例T1DM(T1DM)患者及40名正常对照(NC)者双侧正中神经、腓肠神经2000、250、5 Hz CPT，并检测两组HbA₁c、尿白蛋白/肌酐（UAlb/Cr）等代谢指标。  结果  与NC组比较，T1DM组双侧正中神经及腓肠神经2000、250、5 Hz频率下CPT降低（P＜0.05）；T1DM组正中神经损伤数量与同侧腓肠神经损伤数量比较，异常率偏低（左侧c²=16.99，P<0.01；右侧c²=10.34，P<0.01）；T1DM组CPT正常亚组与CPT异常亚组HbA₁c水平比较，差异无统计学意义。二元Logistic回归分析显示，高HbA₁c是发生DPN的独立危险因素。  结论  CPT可以早期发现T1DM患者周围神经受损，同时DPN下肢神经较上肢神经易损， DPN患者HbA₁c较高，且高HbA₁c是DPN的独立危险因素。

【关键词】糖尿病，1型；糖尿病周围神经病变；电流感觉阈值

Evaluation of Current perception threshold for early diagnosis in Type 1 diabetes with diabetic peripheral neuropathy  FANG Chen,LÜ Sheng -long,WU Hai-ying，et al. Department of Endocrinology，the Second Affiliated Hospital of Soochow University，Suzhou 215000，China

Corresponding author：HU Ji，E-mail：huji@suda.edu.com

【Abstract】Objective   Current perception threshold (CPT) in patients with type 1 diabetes mellitus were tested by Neurometer® CPT/C nerve measuring instrument to evaluate the injury severity of each fiber, thus to provide valid evidence for the early diagnosis of diabetic peripheral neuropathy (DPN). Methods  52 patient with T1DM (T1DM group) and 40 normal control group (NC group) were enrolled in this study. CPT value of bilateral median nerve and sural nerve at 2000 Hz, 250 Hz, 5 Hz were measured in all subjects. HbA₁c, urinary albumin creatinine ratio (UAlb/Cr) were tested. Result  CPT values of bilateral median nerve and sural nerve at 2000 Hz, 250 Hz, and 5 Hz frequency were significantly lower in T1DM group than in NC group (P <0.01).The number of diabetic nerve damage was significantly lower in median nervethan insural nerve on one side (left sidec²=16.99,P< 0.01；right sidec²=10.34,P< 0.01). The HbA₁c level was similar between CPT normal and CPT abnormal patients in T1DM group. Binary logistic regression analysis showed that high HbA₁c is an independent risk factor for DPN. Conclusion  CPT  can early detect peripheral neuropathy in patients with type 1 diabetes. The lower limb nerve in diabetic peripheral neuropathy is more vulnerable than upper limb nerve. HbA₁c level was higher in type 1 diabetes with DPN, and high HbA₁c is an independent risk factor for DPN.

【Key Words】 Diabetes mellitus, type 1； Diabetic peripheral neuropathy（DPN）； Current perception threshold（CPT）