Fan Xiong, Qian Wang, Yun Hu, Xiao Jiang, Lin Liu, Yumeng Han, Qing Jiang, Shiqin Yuan, Lan Xu
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引用次数: 0
摘要
糖尿病周围神经病变(DPN)和自主神经病变在2型糖尿病(T2DM)患者中普遍共存。目前糖尿病神经病变的评估工具仍然复杂和有限。我们旨在探讨DPN合并T2DM患者颈迷走神经的声像图变化。材料与方法:根据肌电结果将T2DM患者分为DPN组(n = 44)和非DPN组(NDPN, n = 43)。另外纳入了43名健康对照(CON)。所有受试者均行迷走神经高频超声(HFU)检查。结果:与对照组相比，T2DM患者迷走神经蜂窝状结构降低，p < 0.001。DPN组右侧迷走神经横截面积(CSA)高于NDPN组(1.60±0.52比2.00±0.57 mm2, p =0.001)。Logistic回归分析显示右侧迷走神经CSA是DPN发生的危险因素(比值比[OR] = 3.924, p = 0.002)。右侧迷走神经CSA与糖尿病病程呈正相关(p = 0.003)，与尺神经、正中神经和腓总神经的运动传导速度(MCV)呈负相关(p均< 0.001)，与尺神经和正中神经的传感器传导速度(SCV)呈负相关(p均< 0.005)。结论:HFU显示DPN患者颈迷走神经增厚，这是糖尿病神经病变的潜在诊断特征。
Ultrasound characteristics of the cervical vagus nerve in patients with type 2 diabetes and diabetic peripheral neuropathy.
Introduction: Diabetic peripheral neuropathy (DPN) and autonomic neuropathy are commonly coexistent in patients with type 2 diabetes mellitus (T2DM). Current assessment tools for diabetic neuropathy remain complicated and limited. We aimed to investigate the sonographic changes of the cervical vagus nerve in DPN patients with T2DM.
Material and methods: Patients with T2DM were divided into a DPN group (DPN, n = 44) and non-DPN controls (NDPN, n = 43) based on electromyogram results. Another 43 healthy controls (CON) were included. High-frequency ultrasound (HFU) of the vagus nerve was performed in all participants.
Results: Compared with controls, the honeycomb structure of the vagus nerve in patients with T2DM decreased, p < 0.001. The DPN group had higher cross-sectional area (CSA) of the right vagus nerve than the NDPN group (1.60 ± 0.52 vs. 2.00 ± 0.57 mm2, p =0.001). Logistic regression showed that right vagus nerve CSA was a risk factor of DPN (odds ratio [OR] = 3.924, p = 0.002). Right vagus nerve CSA was positively correlated with diabetes duration (p = 0.003), and negatively correlated with the motor conduction velocity (MCV) of the ulnar, median, and common peroneal nerves (p < 0.001 for all), as well as the sensor conduction velocity (SCV) of the ulnar and median nerve (both p < 0.005).
Conclusion: HFU shows thickening of the cervical vagus nerve in patients with DPN, which is a potential diagnostic feature of diabetic neuropathy.
期刊介绍：
"Endokrynologia Polska" publishes papers in English on all aspects of clinical and experimental endocrinology. The following types of papers may be submitted for publication: original articles, reviews, case reports, postgraduate education, letters to the Editor (Readers’ Forum) and announcements of scientific meetings, conferences and congresses.
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