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目的证实糖尿病近段神经病的存在以及Ｈ反射在糖尿病近段神经病中的诊断作用。方法通过经典的Ｈ反射和顺向周围神经传导检测方法，对正常组１７６条胫神经、糖尿病组２６８条胫神经进行对比研究。正常胫神经Ｈ波潜伏期（ＨＬ）多元回归方程８．２＋０．５×腿长（ｃｍ）＋０．０６×年龄（岁），再加３．６ｍｓ（２ｓ）为建议的正常参考值上限。结果４４．０％（１１８／２６８）糖尿病组胫神经ＨＬ延长。糖尿病组胫神经中，７４．６％（２００／２６８）ＨＬ大于９５％正常参考值上限，明显高于感觉神经传导速（３８．５％）和运动神经传导速（４３．３％）检测的阳性率（χ２＝１１５．６，Ｐ＜０．０００１）。结论Ｈ反射较常规周围神经传导检测具有更高的诊断敏感性，糖尿病近段神经病的发生可能远较临床诊断的频度为高。
Objective To confirm the existence of diabetic neuropathy and the role of H-reflex in the diagnosis of diabetic neuropathy. Methods The classic tibial nerve of 176 patients and 268 tibial nerves of diabetic group were compared by classical H-reflex and forward peripheral nerve conduction test. Normal tibial nerve H wave latency (HL) multiple regression equation 8.2 + 0.5 × leg length (cm) + 0.06 × age (years), plus 3.6ms (2s) for the recommended upper limit of normal reference. Results 44.0% (118/268) of the tibial nerve HL prolonged in diabetic group. 74.6% (200/268) of HL in diabetic group were higher than the 95% upper limit of normal reference, which was significantly higher than that of sensory nerve conduction velocity (38.5%) and motor nerve conduction velocity (43.3%) Positive rate (χ2 = 115.6, P <0.0001). Conclusions H-reflex has higher diagnostic sensitivity than routine peripheral nerve conduction tests. The incidence of diabetic proximal neuropathy may be much higher than the frequency of clinical diagnosis.