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目的探讨2型糖尿病患者坐骨神经病变的超声图像变化及其在诊断中的应用价值。方法对105例正常对照组及76例具有神经症状的2型糖尿病患者。分别观察正常组及糖尿病患者组坐骨神经的声像图特点,测量并比较两组坐骨神经前后径(D1)、横径(D2)及横切面积(CSA)。结果以正常组的CSA为标准,将糖尿病患者的坐骨神经分为3组:(1)等大组(31例):坐骨神经的D1、D2及CSA与正常组比较无统计学差异(P均>0.05),内部回声与正常组相同。(2)增大组(26例):坐骨神经增大,其中12例可见坐骨神经局部回声降低,8例可见纵行条纹模糊。D1、D2及CSA增大,与正常组比较,差异有统计学意义(P均<0.01)。(3)缩小组(19例):坐骨神经变细,纵行条纹减少,内部低回声区减少。D1、D2及CSA减少,与正常组比较差异有统计学意义(P均<0.01)。结论超声成像能够观察糖尿病坐骨神经的变化,为临床提供有价值的诊断资料。
Objective To investigate the changes of sciatic nerve lesions in type 2 diabetic patients and their diagnostic value. Methods 105 cases of normal control group and 76 patients with neurological symptoms of type 2 diabetes. The characteristics of sciatic nerve in normal group and diabetic group were observed. The anteroposterior diameter (D1), transverse diameter (D2) and cross-sectional area (CSA) of the sciatic nerve were measured and compared. Results The CSA of the normal group was used to divide the sciatic nerve of diabetic patients into three groups: (1) The other groups (31 cases): There was no significant difference in the D1, D2 and CSA of the sciatic nerve compared with the normal group (all P> 0.05 ), The internal echo is the same as the normal group. (2) In the enlarged group (26 cases), the sciatic nerve increased, of which 12 cases showed reduced local echogenicity of the sciatic nerve and 8 cases showed fuzzy longitudinal striation. D1, D2 and CSA increased compared with the normal group, the difference was statistically significant (P all <0.01). (3) reduced group (19 cases): sciatic nerve thinning, longitudinal stripe reduction, reduced internal hypoechoic area. D1, D2 and CSA decreased compared with the normal group, the difference was statistically significant (P all <0.01). Conclusion Ultrasound imaging can observe the changes of diabetic sciatic nerve and provide valuable diagnostic data for clinic.