The Clinical Application Value Of F Wave In The Diagnosis Of Diabetic Peripheral Neuropathy

Objective:To investigate the clinical value of F wave in the diagnosis of type 2 diabetic peripheral neuropathy,and compare the abnormal rate of F wave in the upper and lower limb nerve,and the abnormal rate of the parameters of F wave.Methods: Randomly selected from October 2015 to December 2015 Dalian Medical University Affiliated Second Hospital of Endocrinology,81 cases of type 2 diabetic patients,patients above is reached in 1999 International Diabetes diagnostic criteria for diabetes mellitus and have been eliminated from the long-term,a large number of drinking history,medication history,history of exposure to toxins,engaged in heavy labor history,cervical spondylosis,lumbar disease,thyroid disease and its related diseases caused by peripheral neuropathy patients.Patients with a history of myelitis、spinal degenerative disease and a history of stroke were excluded.F wave of motor nerve and nerve conduction velocity in patients with limb movement and sensory nerve were detected by VikingQuest EMG instrument produced by Usa Inc,the specific examination method is to above 2 type diabetes patients’ upper limb nerbe(median nerve,ulnar nerve),the lower nerve(tibial nerve and peroneal nerve)motor nerve conduction velocity(MCV)measurement,the sensory nerve conduction velocity(SCV)was measured in the nerve of the upper limb(median nerve,ulnar nerve the radial nerve),lower limb nerve(sural nerve and superficial peroneal nerve);the median nerve,ulnar nerve,tibial nerve for measurement of F wave recording parameters for the minimum latency of F wave,F wave latency of the long latency,average latency,maximum F wave conduction velocity.Reference Pan Hua et al.127 healthy volunteers as control group in the normal reference value of F wave of Chinese people established in Beijing Tiantan Hospital during 2007-2011.With 81 cases type 2 diabetic patients undergoing NCV(nerve conduction velocity)detection,according to the test results were divided into two groups,a group of NCV normal group,another group of NCV abnormal group,then respectively for the two groups of F wave testing,comparing the conventional NCV test positive rate and F wave parameters test positive rate,and the positive rate comparison of the parameters of F wave,the positive rate of f wave in the upper and lower limbs.Finally motor nerve conduction velocity 、sensory nerve conduction velocity and f wave abnormalities were compared in patients with type 2 diabetes who were asymptomatic.Thus it is concluded that the F wave to the diagnosis of diabetes peripheral neuropathy clinical application value.Results: 1.Group cases of tibial nerve and median nerve,ulnar nerve,F wave abnormal rate one of the highest rate of abnormal nerve for tibial nerve 85.2%(69 cases),compared with median nerve,X~2 = 13.569,P = 0.000;Compared with ulnar nerve,X~2 = 10.414,P = 0.001,the differences were statistically significant.2.Cases,the parameters of F wave abnormal rate of maximum incubation period abnormal rate up to 88.9%(72 cases),compared with minimum incubation period,X~2 = 36.000,P = 0.000;Compared with the average incubation period,X~2 = 18.514,P = 0.000;Compared with F wave arrival rates,X~2 = 72.900,P = 0.000;Compared with F wave conduction velocity biggest,X~2 = 8.562,P = 0.003,P values were less than 0.01,the differences were statistically significant.3.Case group MCV and SCV abnormal rate compared with the rate of F wave abnormal,cases(including NCV normal and abnormal group)in patients with type 2 diabetes SCV and MCV and F wave,the abnormal rate of F wave abnormal rate was 88.9%(72 cases),significantly higher than the SCV 33.3%(27 cases)and abnormal rate of MCV 29.6%(24 cases),P values were less than 0.01,there are statistically significant differences.Cases no statistical difference,SCV and MCV abnormal rate X~2 = 0.258,P = 0.612).4.NCV abnormal group and the NCV normal nerve corresponding parameters with the same name nerve comparison,the median nerve F wave minimum incubation period(t = 3.132,p = 3.132)with statistically significant difference,the maximum incubation period(t = 2.249,p = 0.034),the average incubation period(t = 2.794,p = 0.010),the maximum velocity(t = 2.302,p = 2.302)was statistically significant,other neural corresponding with the same name nerve parameters in two groups had no significant statistical significance,p values were greater than 0.05.5.Group NCV anomaly of tibial nerve,median nerve,ulnar nerve,F wave and the MCV abnormal rate of tibial nerve,median and ulnar nerve F wave abnormal rate was 88.9%(24 cases),88.9%(24 cases),77.8%(21 cases)was obviously higher than the same nerve MCV abnormal rate were 55.6%(15 cases),55.6%(15 cases),44.4%(12 cases),F wave of tibial nerve and median nerve compared with the MCV abnormal rate,P < 0.01,the differences were statistically significant;Ulnar nerve of F wave compared with MCV abnormal rate,P < 0.05,with statistical differences.6.Cases in asymptomatic patients(n = 21),F wave abnormal rate compared with SCV and MCV,F wave abnormal rate was 85.7%(18 cases)was significantly higher than that of the SCV 28.6%(6 cases)and MCV 28.6%(6 cases)abnormal rate,SCV、 MCV were compared and the abnormal rate of F wave,P less than 0.01,has statistically significant difference.Conclusion: 1.F wave has important significance in the early diagnosis of diabetic peripheral neuropathy,it can be suggested that subclinical lesions,and its detection rate was higher than that of sensory nerve and motor nerve conduction velocity.2.The maximum latency of F wave is more sensitive to the diagnosis of diabetic peripheral neuropathy.3.The abnormal rate of F wave in the tibial nerve of the patients with diabetes was higher than that of other abnormal nerve rate.