Đặc điểm lâm sàng, cận lâm sàng và tổn thương thần kinh ngoại vi ở bệnh nhân đái tháo đường type 2=Clinical, paraclinical features and peripheral neuropathy of patients with type 2 diabetes

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Tác giả: Đức Kỷ Ngô, Thị Nga Nguyễn, Thị Thu Thuỷ Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.41-46

Bộ sưu tập: Metadata

ID: 477952

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Mô tả đặc điểm lâm sàng, cận lâm sàng và tổn thương thần kinh ngoại vi ở bệnh nhân đái tháo đường type 2. Phương pháp: Nghiên cứu mô tả cắt ngang, sử dụng Bộ sàng lọc của Vương quốc Anh và điện cơ để đánh giá tổn thương thần kinh ngoại vi trên 113 bệnh nhân điều trị tại khoa Nội tiết, Bệnh viện Hữu Nghị Đa khoa Nghệ An. Kết quả: Tuổi trung bình 64,39 ± 11,55 tuổi, 64,6% từ 60 tuổi trở lên. 50,4% có thời gian phát hiện bệnh dưới 5 năm, 47,8% có BMI ≥ 23 kg/m², 65,5% có tiền sử tăng huyết áp. Đường huyết trung bình khi nhập viện là 11,54 ± 4,26 mmol/l, HbA1c trung bình 8,81 ± 2,05%. 59,3% có triệu chứng thần kinh ngoại vi theo Bộ sàng lọc, 33,6% mức độ nặng. Điện cơ phát hiện 70,8% tổn thương, chủ yếu ở dây thần kinh giữa. 36,3% có microalbumin niệu. Sự khác biệt có ý nghĩa thống kê (p<
0,05) về thời gian tiềm tàng và tốc độ dẫn truyền cảm giác ở dây thần kinh giữa, trụ, và bì bắp chân giữa các nhóm tuổi (<
60 và ≥60 tuổi). Kết luận: Tổn thương thần kinh ngoại vi phổ biến ở bệnh nhân đái tháo đường type 2, đặc biệt ở người cao tuổi. Điện cơ phát hiện tỷ lệ tổn thương cao hơn so với lâm sàng. Kiểm soát đường huyết kém, tăng huyết áp và microalbumin niệu phổ biến. Cần sàng lọc định kỳ bằng cả phương pháp lâm sàng và điện sinh lý.To describe the clinical, paraclinical characteristics, and peripheral neuropathy in Objective: To describe the clinical and paraclinical features, and peripheral nerve damage in patients with type 2 diabetes. Methods: A cross-sectional study utilizing the UK Screening Tool and electromyography to assess peripheral nerve damage in 113 patients treated at the Endocrinology Department of Nghe An General Friendship Hospital. Results: The average age was 64.39 ± 11.55 years, with 64.6% of patients aged 60 or older. Of the patients, 50.4% had been diagnosed with diabetes for less than 5 years, 47.8% had a BMI ≥ 23 kg/m², and 65.5% had a history of hypertension. The mean blood glucose level at admission was 11.54 ± 4.26 mmol/L, and the average HbA1c was 8.81 ± 2.05%. Peripheral neuropathy symptoms were present in 59.3% of patients according to the UK Screening Tool, with 33.6% at a severe level. Electromyography revealed nerve damage in 70.8% of patients, primarily affecting the median nerve. Additionally, 36.3% had microalbuminuria. Statistically significant differences (p<
0.05) were observed in the latency and conduction velocity of the median, ulnar, and sural nerves between age groups (<
60 and ≥60 years). Conclusion: Peripheral neuropathy is prevalent in type 2 diabetes patients, especially among older individuals. Electromyography detected a higher rate of nerve damage compared to clinical assessments. Poor glycemic control, hypertension, and microalbuminuria were common. Routine screening using both clinical and electrophysiological methods is recommended.

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