A Preliminary Study On The Screening Of Peripheral Neuropathy By The Tip Diameter Of Nail Fold Microcirculation

Objective: To study the change of the tip diameter of nail fold microcirculation and its correlation with DPN,and to compare the effectiveness of the detection of the tip diameter of nail fold microcirculation and detection of VPT.Methods: According to the inclusion criteria and exclusion criteria,229 cases of patients with type 2 diabetes were studied as subjects.According to the screening score,the DPN group was divided into two groups: NDPN group(n = 105)and DPN group(n = 124),in which the DPN group was divided into 1 DPN group,2 DPN group,3 DPN group according to the modified Dyke staging standard.The general clinical information of the patients was collected after admission.The tip diameter of nail fold microcirculation was measured by image analysis system.For NDPN group and DPN group,Single factor analysis of variance(ANOVA)was performed.Multiple comparisons were made between stage 1 DPN group,stage 2 DPN and stage 3 DPN group.Pearson correlation analysis was carried out between the apical diameter of loop and the common related factors of DPN.The ROC curve was drawn to compare the efficacy of the tip diameterof and VPT in the diagnosis and screening of DPN.Results: 1.Analysis of general data: a total of 229 patients with diabetes mellitus were included in this study,including 64 males and 105 females in NDPN group,including 50 males and 55 females.2.There was a significant linear correlation between the tip diameter of nailfold loop and VPT,and the correlation coefficient was-0.681,which was negatively correlated with age and the course of diabetes.3.There was significant difference in the tip diameter of nail fold microcirculation between DPN group and NDPN group.The tip diameter of each group was 1 DPN group(11.41±2.82um),2 DPN group(10.38 ±2.48um),3 DPN group(9.10 ±2.677um)respectively.The ANOVA test was performed between the three groups.1 DPN group and 2 DPN group,1DPN group and 3 DPN group,2 DPN group and 3 DPN group were all different with each other(P < 0.05)4.There was significant difference in VPT between NDPN group and DPN group(t=11.79,P < 0.05).In DPN group,the VPT of each group was1 1 DPN group(10.99 ±3.63 v),2DPN group(18.74 ±8.21 v),3 stage DPN(29.40 ±7.70 v)respectively.Compared with stage 1 DPN and stage 2 DPN,stage 1 DPN and stage 3 DPN,stage 2 DPN and stage 3DPN,they were all different with each other(P < 0.05).5.According to the ROC curve of the tip diameter of nail fold microcirculation,the area under the ROC curve was calculated to be 0.787,and calculate the diagnostic threshold point was 11.58 according to the Youden index.The computational sensitivity ≈ 79.03%,the accuracy ≈ 73.36%,the specificity ≈ 66.67%,the positive likelihood ratio ≈(17)(13)(18)(22),the negative likelihood ratio ≈ 0.31.6.According to the ROC curve of VPT,the area under the ROC curve was calculated to be0.916,and the diagnostic threshold point was 9.775.The sensitivity ≈(24)(16)(13)(15)(21)%,the accuracy ≈(22)(23)(13)(20)(16)%,the specificity ≈ 85.89%,the positive likelihood ratio ≈ 2.53,the negative likelihood ratio ≈ 0.14.Conclusion:1.The tip diameter of nail fold microcirculation in DPN group was significantly lower than that in NDPN group.2.The tip diameter of nail fold microcirculation in DPN group decreased with the severity of the disease.3.There was a significant correlation between the apical diameter of nailfold microcirculation and the severity of DPN in diabetic patients.4.The change of apical diameter of nailfold microcirculation has reference value to DPN,but its efficiency is lower than VPT.