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目的探讨糖尿病周围神经病(DPN)患者双下肢肌力与腓总神经运动传导的复合肌肉动作电位(CMAP)波幅的相关性。方法 75例DPN患者,根据患者下肢肌力分为轻度无力组(3级和4级,32例)和肌力正常组(5级,43例)。采用肌电/诱发电位仪记录腓总神经运动传导速度(MCV)、远端潜伏期(DPL)及复合肌肉动作电位(CMAP)的波幅、时限、波形,对数据进行分析。结果轻度无力组MCV减慢10例(31.3%);DPL延长5例(15.6%);肌力正常组MCV减慢13例(30.2%);DPL延长6例(14.0%);两组MCV、DPL参数比较差异无统计学意义(P>0.05)。轻度无力组CMAP平均波幅为(3.3±0.3)m V,肌力正常组为(5.1±0.2)m V,比较差异有统计学意义(P<0.05)。两组平均时限比较差异无统计学意义(P>0.05)。轻度无力组CMAP波幅下降率(40.6%)高于肌力正常组(16.3%),差异有统计学意义(P<0.05);两组时限异常率、CMAP波形变异率比较差异无统计学意义(P>0.05)。结论 CMAP的波幅与DPN患者肌力相关,可以反映其运动神经轴索损害,结合观察CMAP波形变异有助于提高DPN的检出率。
Objective To investigate the relationship between muscular strength of the lower extremities and the amplitude of compound muscle action potential (CMAP) in the peroneal nerve during diabetic peripheral neuropathy (DPN). Methods 75 patients with DPN were divided into mild weakness group (grade 3 and grade 4, 32 cases) and normal muscular strength group (grade 5, 43 cases) according to their muscle strength. Data were analyzed using electromyography / evoked potentiometer for the amplitude, duration, and waveform of the common motor nerve conduction velocity (MCV), distal latency (DPL), and complex muscle action potential (CMAP) Results MCV of mild weakness group was reduced by 10 (31.3%), extension of DPL was 5 (15.6%), MCV of normal strength group was reduced by 13 (30.2%), DPL was prolonged by 6 (14.0% There was no significant difference in DPL parameters (P> 0.05). The mean amplitude of CMAP was (3.3 ± 0.3) m V in Mild weakness group and (5.1 ± 0.2) m V in Normal muscle strength group, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in mean time (P> 0.05). The decrease rate of CMAP amplitude in mild weak group (40.6%) was higher than that in normal muscle group (16.3%), the difference was statistically significant (P <0.05). There was no significant difference in the abnormal rate of CMAP waveforms between two groups (P> 0.05). Conclusion The amplitude of CMAP correlates with muscle strength in patients with DPN, which can reflect axonal damage of motor axons. Observing CMAP waveform variations can help increase the detection rate of DPN.