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目的初步探讨振动感觉阈值检查(vibration perception thresholds test,VPT)与糖尿病外周神经病变临床常用检查的相关性。方法对487例2型糖尿病者进行了VPT、10g单纤维尼龙丝检查(10gSemmes-Weinstein monofilament examination,SWME)、温度觉及128Hz振动觉检查,分析各检查的相关性,同时比较各检查的差异。结果多元回归分析显示影响VPT的因素为年龄(OR=1.062,95%CI:1.038-1.086,P<0.001)和空腹血糖水平(OR=1.085,95%CI:1.003-1.173,P=0.041);VPT与SWME、温度觉检查及128Hz振动觉检查均明显相关,相关系数分别为0.176、0.152及0.240(P值均<0.01);VPT与SWME、温度觉检查及128Hz振动觉检查的观察一致率分别为49.5%、59.8%及51.1%,Kappa值分别为0.106、0.151及0.138(P值均<0.01);SWME及128Hz振动觉检查异常但VPT检查正常的比例低,分别为2.7%及1.2%。结论VPT也应作为临床筛查糖尿病外周神经病变的一线方法。
Objective To investigate the correlation between Vibration perception thresholds test (VPT) and clinical tests of diabetic peripheral neuropathy. Methods The 487 patients with type 2 diabetes were examined by VPT, 10g Semen-mononilas examination (SWME), temperature and 128Hz vibration tests. The correlations between the two tests were analyzed and the differences between the tests were compared. Results The multiple regression analysis showed that the factors influencing VPT were age (OR = 1.062, 95% CI: 1.038-1.086, P <0.001) and fasting blood glucose (OR = 1.085,95% CI: 1.003-1.173, P = 0.041) VPT was significantly correlated with SWME, temperature and 128Hz vibration tests, and the correlation coefficients were 0.176,0.152 and 0.240 respectively (all P <0.01). The agreement rates between VPT and SWME, temperature and 128Hz were Were 49.5%, 59.8% and 51.1%, respectively. The Kappa values were 0.106, 0.111 and 0.138, respectively (all P <0.01). The rates of abnormal SWT and 128 Hz vibration examination but normal VPT were low, 2.7% and 1.2% respectively. Conclusion VPT should also be used as a first-line method for clinical screening of diabetic peripheral neuropathy.