糖尿病合并高血压患者中枢传导时间分析
【摘要】 目的：探讨糖尿病合并高血压患者体感诱发电位中枢传导时间(CCT)的改变与单纯糖尿病患者之间的差异和意义。 方法应用体感诱发电位刺激胫后神经的检测方法对42例糖尿病患者、40例糖尿病合并高血压患者及43例正常人的CCT进行分析、比较。结果两组糖尿病患者与正常对照组相比，其中枢传导时间L1-2椎旁横突处(FO)-P1时间延长，P1波波幅下降。其中糖尿病合并高血压患者组的FO-P1的波间期(IPL)时间明显延长，P1波波幅明显下降，与单纯糖尿病组比较，二者差异有显著性(P<0.01)。结论糖尿病合并高血压病患者的中枢神经系统受累较单纯糖尿病患者更为重。
关键词：糖尿病糖尿病合并高血压体感诱发电位中枢传导时间
Study on central conduction time in patients with diabetic mellitus and hypertension
[Abstract] Objective: To investigate the difference and its significance of central conduction time (CCT) of somatosensory evoked potential (SSEP) between patients with only diabetic mellitus and diabetic mellitus combined with hypertension. Methods: SSEPs were first got through stimulating posterior tibial nerves in 42 patients with diabetic mellitus, 40 patients with diabetic mellitus and hypertension and 43 normal peoples. CCTs were then analyzed and compared with the method of t-test among the above three groups. Results: Compared with the normal group, the interpeak latency (IPL) of FO (at Lumbal 1 transversal process)-P1 of SSEP was significantly longer, and the P1 amplitude statistically lower in patients with only diabetic mellitus and diabetic mellitus combined with hypertension. The IPL in patients with only diabetic mellitus was significantly longer, and P1 amplitude statistically decreased compared with the patients with diabetic mellitus and hypertension. Conclusion: The central nervous system was more seriously impaired in patients with diabetic mellitus and hypertension than that in patients with only diabetic mellitus.
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[Key words] Diabetic mellitus； Diabetic mellitus combined with hypertension；SEP；Central conduction time
糖尿病和高血压病都是中老年人的常见病、多发病，近年来糖尿病合并高血压病的患者日益增多，且年龄越来越年轻化。在糖尿病人群中，高血压的存在加重了心血管病变的危险性，此方面的研究报道也较多，但高血压对糖尿病患者中枢神经系统的影响，国内相关报道较少。我院神经电生理室对2001年5月至2003年3月诊治的40例糖尿病合并高血压病患者和42例单纯糖尿病患者进行了体感诱发电位检查，对两组患者的中枢传导时间进行比较和分析。
体感诱发电位检查作为一种对中枢神经系统的检查，被认为是一种较客观的检测手段。体感诱发电位检查可以反映病理改变的部位和程度, 不同波形成份的异常反映该波形所指部位存在着病理改变; 病理改变越重，体感诱发电位的潜伏期越长，波幅衰减越明显。本文应用体感诱发电位对82例糖尿病患者进行中枢传导时间的测定，结果提示刺激胫后神经时中枢传导时间 L1-2椎旁横突处(FO)-P1时间延长，P1波幅下降，与正常组比较差异有统计学意义(P<0.01)。其中40例糖尿病合并高血压病患者组FO-P1波间期(IPL)时间明显延长，P1波波幅明显下降，与单纯糖尿病组比较，有显著的差异。中枢传导时间研究的结果提示糖尿病合并高血压病患者的中枢神经系统受累较单纯糖尿病患者为重。
糖尿病时多有脊髓、脑干、丘脑至皮层的感觉传导功能不同程度的受累，即使是临床上和CT检查中均没有中枢神经受损者，也开始有中枢传导时间的改变，而糖尿病合并高血压则加速了糖尿病此种慢性并发症的发生和发展。糖尿病促进了高血压的发生、发展，高血压又加重了糖尿病引起的各种损害。两者互相促进，互为因果，形成恶性循环。为了阻断此恶性循环，在积极控制糖尿病的同时，还应有效地控制血压，使之达到正常范围。
参考文献
1刘新民主编. 实用内分泌学. 第2版. 北京：人民军医出版社, 1997.280., 百拇医药(谢可新 赵宗彦)
关键词：糖尿病糖尿病合并高血压体感诱发电位中枢传导时间
Study on central conduction time in patients with diabetic mellitus and hypertension
[Abstract] Objective: To investigate the difference and its significance of central conduction time (CCT) of somatosensory evoked potential (SSEP) between patients with only diabetic mellitus and diabetic mellitus combined with hypertension. Methods: SSEPs were first got through stimulating posterior tibial nerves in 42 patients with diabetic mellitus, 40 patients with diabetic mellitus and hypertension and 43 normal peoples. CCTs were then analyzed and compared with the method of t-test among the above three groups. Results: Compared with the normal group, the interpeak latency (IPL) of FO (at Lumbal 1 transversal process)-P1 of SSEP was significantly longer, and the P1 amplitude statistically lower in patients with only diabetic mellitus and diabetic mellitus combined with hypertension. The IPL in patients with only diabetic mellitus was significantly longer, and P1 amplitude statistically decreased compared with the patients with diabetic mellitus and hypertension. Conclusion: The central nervous system was more seriously impaired in patients with diabetic mellitus and hypertension than that in patients with only diabetic mellitus.
, http://www.100md.com
[Key words] Diabetic mellitus； Diabetic mellitus combined with hypertension；SEP；Central conduction time
糖尿病和高血压病都是中老年人的常见病、多发病，近年来糖尿病合并高血压病的患者日益增多，且年龄越来越年轻化。在糖尿病人群中，高血压的存在加重了心血管病变的危险性，此方面的研究报道也较多，但高血压对糖尿病患者中枢神经系统的影响，国内相关报道较少。我院神经电生理室对2001年5月至2003年3月诊治的40例糖尿病合并高血压病患者和42例单纯糖尿病患者进行了体感诱发电位检查，对两组患者的中枢传导时间进行比较和分析。
体感诱发电位检查作为一种对中枢神经系统的检查，被认为是一种较客观的检测手段。体感诱发电位检查可以反映病理改变的部位和程度, 不同波形成份的异常反映该波形所指部位存在着病理改变; 病理改变越重，体感诱发电位的潜伏期越长，波幅衰减越明显。本文应用体感诱发电位对82例糖尿病患者进行中枢传导时间的测定，结果提示刺激胫后神经时中枢传导时间 L1-2椎旁横突处(FO)-P1时间延长，P1波幅下降，与正常组比较差异有统计学意义(P<0.01)。其中40例糖尿病合并高血压病患者组FO-P1波间期(IPL)时间明显延长，P1波波幅明显下降，与单纯糖尿病组比较，有显著的差异。中枢传导时间研究的结果提示糖尿病合并高血压病患者的中枢神经系统受累较单纯糖尿病患者为重。
糖尿病时多有脊髓、脑干、丘脑至皮层的感觉传导功能不同程度的受累，即使是临床上和CT检查中均没有中枢神经受损者，也开始有中枢传导时间的改变，而糖尿病合并高血压则加速了糖尿病此种慢性并发症的发生和发展。糖尿病促进了高血压的发生、发展，高血压又加重了糖尿病引起的各种损害。两者互相促进，互为因果，形成恶性循环。为了阻断此恶性循环，在积极控制糖尿病的同时，还应有效地控制血压，使之达到正常范围。
参考文献
1刘新民主编. 实用内分泌学. 第2版. 北京：人民军医出版社, 1997.280., 百拇医药(谢可新 赵宗彦)