| Objective: The nerve conduction velocity (NCV) of Type2diabetes（T2DM）inpatientswas measured to investigate the relationship between age, disease duration,disease location and nerve conduction velocity of diabetic peripheral neuropathy(DPN), the DPN relevant factors about NCV and incubation period were analyzed.Method: Selecting300cases of T2DM medicare inpatients in the202th hospital ofpeople’s liberation army during January1,2013to March31,2013, whose glycemiclevelconform to the WHO announced diabetes diagnostic criteria in1999.288cases ofthe healthy control group were selected from the202th hospital medical center andinformed consent was obtained. Nerve conduction velocity was measured on588peoplescreening for NCV abnormal patients. According to test results T2DM patients weredivided into NCV positive and the NCV negative group, while incubation period andconduction velocity of sensory and Motor nerves were analyzed, and combined withclinical parameters to conduct a comprehensive analysis of the nerve conductionvelocity. Information collection in patients with type2diabetes including age, diseaseduration, past medical history, present medical history, also urged the T2DM patientsand healthy control group subjects fasting for6-8hours and the next morningpumping elbow venous blood for determination of the fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1C), fasting C-peptide, postprandial2hour bloodglucose and serum C-peptide, then sent to clinical laboratory test for group comparativeanalysis.ResultAnalysis of NCV abnormal rateThere were230cases with abnormal NCV in300inpatients with T2DM,percentage of abnormality was76.66%. There were1348nerves with abnormal NCV in 4200detected nerves,percentages of abnormality was32.09%.55%in MCV of thetibial nerve,44.6%in SCV of the sural nerve,40.66%in SCV of the median nerve,31%in MCV of the peroneal nerve,29%in MCV of median nerve,17%in SCV of ulnarnerve,7.33%in MCV of ulnar nerve, respectively, abnormal rate of the tibial nerve wasthe highest in NCV measurement.1、 Determination results of MCV and SCVIn measurement of MCV,734of2400nerves detected were abnormal, abnormalrate was30.58%; In measurement of SCV,614of1800nerves detected were abnormal,abnormal rate was34.11%. Because N equals4200greater than40and all T (theoreticalfrequency) is greater than5, using non correction formula to calculate X2values. Thetwo groups were compared, X2is equal to5.87. Check X2critical values,X20.025,1=5.02，X20.01,1=6.63，X20.01,1＞X2＞X20.025,1,0.01＜P＜0.025, thedifference was statistically significant.3、The NCV measurement result of the upper and lower limbsThere were anbnormal564nerves detected in2400of uppper limbs, percentageof abnormality was23.5%; There were anbnormal784nerves detected in1800of lowerlimbs, percentage of abnormality was43.55%. Because N equals4200greater than40and all T (theoretical frequency) is greater than5, using non correction formula tocalculate X2values. The two groups were compared, X2is equal to189.8. Check X2critical values, X20.005,1=7.88， X2＞X20.005,1, P＜0.005, the difference wasstatistically significant.4、 The NCV measurement result of clinical symptoms group and no clinicalsymptoms groupThere were90patients with abnormal NCV in130patients of no clinicalsymptoms group, percentage of abnormality was69.23%. There were140patients withabnormal NCV in170patients of clinical symptoms group, percentage of abnormalitywas82.35%. Because N equals4200greater than40and all T (theoretical frequency) isgreater than5, using non correction formula to calculate X2values. The two groupswere compared, X2is equal to7.09. Check X2critical values,X20.01,1=6.63，X20.005,1=7.88，X20.01,1＜X2＜X20.005,1，0.005＜P＜0.01, the difference was statisticallysignificant.5、 The relationship between duration of diabetes and NCV The median nerve MCV and SCV,ulnar nerve MCV and SCV,tibial nerveMCV,sural nerve SCV, peroneal nerve MCV gradually slowed down with the extensionof course.30.46%in MCV of the tibial nerve,29.5%in MCV of the median nerve,28.63%in MCV of the peroneal nerve,27.35%in MCV of the ulnar nerve,22.51%inSCV of median nerve,22.32%in SCV of ulnar nerve,21.4%in SCV ofsuralnerve,respectively,The percentage of tibial nerve’s slow amplitude was the highestin NCV measurement.6、 The relationship between age and MCVCompared with the control group,the MCV of median nerve, ulnar nerve, tibialnerve, peroneal nerve slowed down in groups of age <20years old,20-29years old,30-39years old and40-49years old, but the difference were not statistically significant(P>0.05);MCV slowed down obviously in age50-59years old group, and thedifference was statistically significant (P <0.05); The more obvious declinations wereobserved in age60-69years old group and age over70group, the difference werestatistically significant (P＜0.01) in both groups.7、The relationship between age and SCVCompared with the control group, the SCV of median nerve, ulnar nerve, suralnerve slowed down in groups of age <20years old,20-29years old,30-39years oldand40-49years old, but the difference were not statistically significant (P>0.05).SCV slowed down obviously in age50-59years old group, and the differencewas statistically significant (P <0.05); The more obvious declinations were observedin age60-69years old group and age over70group, the difference were statisticallysignificant (P＜0.01) in both groups.8、The NCV comparison among the groupsCompared with the control group, median nerve MCV, SCV, ulnar nerve MCV,SCV, tibial nerves MCV, sural nerve SCV,peroneal nerve MCV in NCV negativegroup were decreased slightly, but the difference were not statistically significant (P>0.05); While median nerve MCV, ulnar nerve SCV, tibial nerve MCV, sural nerveSCV in NCV positive group were obvious decreased, the difference were statisticallysignificant (P <0.05); The more obvious declinations were observed in Median nerveSCV, ulnar nerve MCV, peroneal nerve MCV, the difference were statisticallysignificant (P <0.01). Compared with NCV negative group, median nerve MCV, ulnar nerve SCV, tibial nerve MCV, sural nerve SCV in NCV positive group wereobvious reduced, and the difference were statistically significant (P <0.05); Themore obvious declinations were observed in median nerve SCV, ulnar nerve MCVperoneal nerve MCV, the difference were statistically significant (P <0.01).9、The incubation period comparison among the groupsCompared with the control group, the incubation period of the median nerveMCV, SCV, ulnar nerve MCV, SCV, tibial nerves MCV, sural nerve SCV, peronealnerve MCV in NCV negative group have increased slightly, but no statisticalsignificance (P>0.05); while median nerve MCV, SCV, the ulnar nerve SCV, tibialnerve MCV, sural nerve SCV in NCV positive group were obvious increased, thedifference were statistically significant (P <0.01), no obvious changes were observedin the ulnar nerve MCV, peroneal nerve MCV and the difference were not statisticallysignificant (P>0.05). Compared with NCV negative group, median nerve MCV、SCV, ulnar nerve SCV, tibial nerve MCV, sural nerve SCV were obvious increased inNCV positive group, the difference were statistically significant (P <0.01), ulnarnerve MCV, peroneal nerve MCV did not change obviously, the difference were notstatistically significant (P>0.05).10. Comparative analysis of factors related to DPN clinicalCompared with control group, the FPG、2hPG in NCV negative group wereobvious higher, the difference were statistically significant (P <0.01);2hourC-peptide decreased obviously, the difference was statistically significant (P<0.01);HbA1C increases, the difference was statistically significant (P <0.05); no obviouschange was observed in fasting C-peptide, the difference was not statisticallysignificant (P>0.05). In NCV positive group the FPG,2hPG and HbA1C wereobvious increased, the difference were statistically significant (P <0.01);2hC-peptidedecreased, the difference was statistically significant (P <0.01); no change in fastingC-peptide, the difference was not statistically significant (P>0.05); compared withthe NCV negative groups, FPG in NCV positive group was obviously higher, thedifference was statistically significant (P <0.01); while2hC-peptide decreased, thedifference was statistically significant (P <0.01); HbA1C and2hPG increased, thedifference were statistically significant (P <0.05); no significant change was observedin fasting C-peptide, the difference was not statistically significant (P>0.05). Conclusion1、The NCV abnormality rate of T2DM medicareinpatientswho participate in theNCV determination was76.66%,of which the tibial nerve MCV abnormal rate ishighest, at55%.2、The slower amplitude of the tibial nerve MCV was an average of30.46%,whichis the most serious lesions in the motor nerve; The slower amplitude of the mediannerve SCV was an average of22.51%,which is the most serious lesions in the sensorynerves.3、Nerve conduction velocity gradually slowed down with the growth of the age orthe prolongation of the course.4、 The NCV abnormal rate of lower limb was higher than that of upper limb(43.55%and23.5%), abnormal rate of SCV was higher than that of MCV (34.11%and30.58%). |
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