Study on the tibial neuropathy risk of diabetes mellitus by high frequency ultrasound,shear wave elastography and clinical indicators

SUN Ran; LIANG Danyan; WU Guozhu; LIU Qian; HONG Hua

doi:10.16245/j.cnki.issn1008-6978.2020.03.011

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Study on the tibial neuropathy risk of diabetes mellitus by high frequency ultrasound,shear wave elastography and clinical indicators

更新时间：2021-10-08

- Study on the tibial neuropathy risk of diabetes mellitus by high frequency ultrasound,shear wave elastography and clinical indicators
- Journal of Clinical Ultrasound in Medicine Vol. 22, Issue 3, Pages: 189-193(2020)
- 作者机构：
  
  内蒙古自治区人民医院超声医学科
- 作者简介：
- 基金信息：
- DOI：10.16245/j.cnki.issn1008-6978.2020.03.011
  CLC： R445.1;R587.2
- Published：2020，
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[1]孙冉,梁丹艳,吴国柱,刘倩,红华.高频超声与剪切波弹性成像结合临床指标评估糖尿病患者胫神经病变风险[J].临床超声医学杂志,2020,22(03):189-193.

SUN Ran, LIANG Danyan, WU Guozhu, et al. Study on the tibial neuropathy risk of diabetes mellitus by high frequency ultrasound,shear wave elastography and clinical indicators. [J]. Journal of Clinical Ultrasound in Medicine 22(3):189-193(2020)
[1]孙冉,梁丹艳,吴国柱,刘倩,红华.高频超声与剪切波弹性成像结合临床指标评估糖尿病患者胫神经病变风险[J].临床超声医学杂志,2020,22(03):189-193. DOI： 10.16245/j.cnki.issn1008-6978.2020.03.011.

SUN Ran, LIANG Danyan, WU Guozhu, et al. Study on the tibial neuropathy risk of diabetes mellitus by high frequency ultrasound,shear wave elastography and clinical indicators. [J]. Journal of Clinical Ultrasound in Medicine 22(3):189-193(2020) DOI： 10.16245/j.cnki.issn1008-6978.2020.03.011.

摘要

目的探讨高频超声与剪切波弹性成像结合临床指标评估2型糖尿病周围神经病变患者胫神经病变风险的临床应用价值。方法选取我院糖尿病患者72例

其中周围神经病变患者34例（DPN组）

无周围神经病变患者38例（NDPN组）

比较两组患者性别、年龄、病程、体质量指数（BMI）、同型半胱氨酸（Hcy）、胰岛素样生长因子-1（IGF-1）、糖化血红蛋白（HbA1c）

以及高频超声所测参数胫神经的左右径、前后径、横截面积（CSA）及剪切波弹性成像所测弹性模量值;分析超声参数与实验室指标的相关性;对临床资料、实验室指标、超声参数进行多因素分析

并对结果进行量化评分。结果 DPN组患者的年龄、病程均高于NDPN组（均P<0.05）

性别、BMI差异无统计学意义;DPN组胫神经左右径、前后径、CSA、弹性模量值、HbA1c、Hcy均高于NDPN组

IGF-1低于NDPN组

差异均有统计学意义（均P<0.05）;胫神经左右径与Hcy、HbA1c呈正相关（r=0.339、0.288

均P<0.05）;前后径与IGF-1呈负相关（r=-0.406

P<0.05）;CSA与Hcy、HbA1c呈正相关（r=0.351、0.257

均P<0.05）

与IGF-1呈负相关（r=-0.334

P<0.05）;弹性模量值与Hcy、HbA1c呈正相关（r=0.246、0.192

均P<0.05）。多因素分析结果显示

病程、CSA、弹性模量值、HbA1c是DPN的独立危险因素（OR=3.267、1.925、1.117、3.542

均P<0.05）

而IGF-1是保护因素（OR=0.892

P=0.004）;列线图结果显示评分达180分

周围神经病变的风险达70%。结论高频超声与剪切波弹性成像结合临床指标可评估糖尿病周围神经病变患者胫神经病变风险

其中病程、CSA、弹性模量值及HbA1c的增高是评估糖尿病周围神经病变患者胫神经病变的独立危险因素

而IGF-1增高是保护因素。

Abstract

Objective To investigate the clinical value of high frequency ultrasound and shear wave elastography（SWE）combined with clinical indicators in the evaluation of tibial neuropathy risk in type 2 diabetic patients.MethodsSeventy-two cases of diabetes

including 34 cases of peripheral neuropathy（DPN group）and 38 cases of non-peripheral neuropathy（NDPN group）were enrolled in this study.Data of gender

age

disease course

body mass index（BMI）

glycosylated hemoglobin（Hb A1 c）

serum insulin-like growth factor-1（IGF-1）

plasma homocysteine（Hcy）

left-right diameter

the anterior-posteriordiameter

cross-sectional area and elasticity measured by shear wave elastography were collected and compared between the twogroups.The correlation between ultrasonic parameters and laboratory indexes was analyzed.Multivariate analysis of clinical data

laboratory indicators

ultrasound parameters

and quantitative scoring of the results.ResultsThe age

disease course in the DPNgroup were higher than those of the NDPN group（both P<0.05）

the gender and BMI were not statistically significant between thetwo groups. In the DPN group

the left-right diameter

the anterior-posterior diameter

CSA

the elastic modulus of the tibialnerve

Hb A1 c and Hcy were higher than those of the NDPN group

while the IGF-1 was lower than that of the NDPN group（allP<0.05）.Hcy and Hb A1 c were positively correlated with the tibial nerve diameter

CSA and elastic modulus of tibial nerve（r=0.339

0.288

0.351

0.257

0.246

0.192

all P<0.05）

while IGF-1 was negatively correlated with anterior-posterior diameterand CSA（r=-0.406

-0.334

both P<0.05）.Multi-factor analysis results showed that disease course

CSA

the elastic modulus

Hb A1 c were independent risk factors for DPN（OR=3.267

1.925

1.117

3.542

all P<0.05）

while IGF-1 was a protective factor（OR=0.892

P=0.004）. The nomogram results showed a score of up to 180 points for a 70% risk of peripheral neuropathy.ConclusionHigh frequency ultrasound and SWE combined with clinical indicators is potentially used to evaluate tibialneuropathy for patients with diabetes mellitus

among them

the increase in disease course

CSA

the elastic modulus

and Hb A1 care independent risk factors to evaluate tibial neuropathy

while the increase in IGF-1 is a protective factor.

关键词

超声检查高频剪切波弹性成像周围神经病变糖尿病胫神经病变IGF-1HbA1cHcy

Keywords

Ultrasonographyhigh frequencyShear wave elastographyPeripheral neuropathydiabetes mellitusTibial neuropathyIGF-1HbA1cHcy

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