Correlation Analysis Between Ultrasonic Feature And Michigan Neuropathy Screening Instrument In Type 2 Diabetic Mellitus

Background Rising incidence of diabetes in recent years, has become one of the important disease threat to human health, so diabetic peripheral neuropathy(DPN) is one of the severe and mostcommon complications of diabetes, patients mainly with distal extremities abnormal sensation, the person that weigh can lead to limb infection, ulcer and gangrene or even amputation. So the DPN early discovery, early treatment, patients can reduce pain, delays the development of disease control, to improve the life quality of patients and prognosis plays an important role.Objectives Ultrasonic observation and measurement of diabetes patients with common fibula nerve and tibial nerve, comparison between groups of the ultrasonographic characteristics and ultrasonic morphology parameters, and explore the correlation between its and michigan neuropathy screening instrument(MNSI).Methods Choose between January 2014 and October 2014, check- in department of endocrinology, tangshan gongren hospital, 95 cases of patients with type 2 diabetes. All consistent with World health organization in 1999 patients with diabetes diagnostic criteria, and with the exception of type 1 diabetes, lumbar disease, cerebrovascular disease cause of neuropathy patients. The 95 cases of patients with type 2 diabetes common fibula nerve and tibial nerve for doing high- frequency ultrasound, measured anteroposterior dimension, transverse diameter, and tracing method to measure the crosssectional area, observe changes of nerve sonographic findings was at the same time; And its application to michigan neuropathy screening instrument.According to clinical symptoms and physical signs of peripheral neuropathy to divide into groups, including diabetes without peripheral neuropathy symptoms group(NDPN group) 53 cases and diabetes with peripheral neuropathy symptoms group(DPN) 42 cases; choosed 30 healthy volunteers for normal control group(NC group). According to the scores of michigan neuropathy screening instrument to divide into groups,(0 ~ 2.4 points)32 cases,(2.5 ~ 4.4 points) 31 cases and(≥4.5 points) 32 cases.Results 1 Ultraphonic morphological parameters of DPN group were larger than those of NDPN group(P<0.05). 2 O nly small part NDPN group, the echo feactures of common fibula nerve and tibial nerve showed that the fasciculus echo slightly degraded,the” screen cloth” structure obscured, the epineurium thicked and unsmoothed, the demarcation with neighbourhood structures was less clear, blood flow signal increased; but most of DPN group, the echo feactures of common fibula nerve and tibial nerve showed that the fasciculus echo degraded, the” screen cloth” structure obscured, the epineurium thicked and unsmoothed, the demarcation with neighbourhood structures was less clear, blood flow signal increased(P<0.05). 3 In DPN group, ultrasonic features of common fibula nerve changed early than tibial nerve(P<0.05).4 The ultrasonic features of common fibula nerve gradual different in each stage of the MNSI scores(all P<0.05).5 The patients with low fasciculus echo, vagued “screen cloth” structure, epineurium thicked and unsmoothed and demarcation with neighbourhood structures in stage of the MNSI 2.5 ~ 4.4 points and ≥4.5 points was more than the MNSI 0 ~ 2.4 points(all P<0.05).6 In stage of the MNSI 2.5 ~ 4.4 points and ≥4.5 points, ultrasonic features of common fibula nerve changed early than tibial nerve(P<0.05).7 There was a positive correlation between the nerves’ s anteroposterior dimension, transverse diameter, cross-sectional area and michigan neuropathy screening instrument(P<0.05).Conclusions 1 In patients of DPN, there were some characteristic in the common fibula nerve and tibial nerve for morphology parameters and ultrasound feactures, and common fibula nerve ultrasound features changes may earlier than tibial nerve. 2 Certain correlation was observed between michigan neuropathy screening instrument and ultrasonic feature in type 2 diabetic mellitus patients; the higher michigan neuropathy screening instrument scores, the greater chance of nerve appear abnormal sonographic features.