【作者】 宋庆芳； 安旭娜； 宋光耀；

【Author】 Songqing-fang;Anxu-na;Songguang-yao;Department of Endocrinology,The Third Hospital of Hebei Medical University;Hebei Province People’ s Hospital;

【机构】 河北医科大学第三医院内分泌科； 河北省人民医院；

【摘要】 目的:探讨2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的相关临床危险因素。方法:选择2007年1月至2007年12月,临床确诊为2型糖尿病的住院患者567例,男314例,女253例,年龄28-78岁,平均57.34岁。根据双下肢肌电电生理检查分为糖尿病周围神经病变组325例,糖尿病非周围神经病变组232例。分别测定体重指数、收缩压、舒张压、空腹血糖、胰岛素及C肽,餐后2小时血糖、胰岛素及C肽,糖化血红蛋白、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、载脂蛋白-A(Apo-A)、载脂蛋白-B(Apo-B)、尿白蛋白/肌苷比值(尿A/C)等指标。对每个指标进行单因素分析,然后进行Logistic多因素分析。结果:(1)糖尿病周围神经病变组的年龄、病程、收缩压、舒张压与非周围神经病变组比较,差异有显著性(P<0.01);而体重指数两组比较差异无显著性(P>0.05);(2)TG、TC、VLDL、LDL在糖尿病周围神经病变组高于非神经病变组,差异有显著性(P<0.01);高密度脂蛋白、载脂蛋白-A(Apo-A)及载脂蛋白-B(Apo-B)两组比较无统计学差异:(3)糖尿病周围神经病变组的糖化血红蛋白、尿A/C水平高于非周围神经病变组,差异有显著性(分别为P<0.05,P<0.01);(4)OGTT试验结果显示:糖尿病神经病变组的空腹血糖以及2小时血糖与糖尿病非神经病变组有显著统计学差异(P<0.01),而空腹以及餐后2小时的胰岛素和C肽水平,糖尿病神经病变组要低于非周围神经变变组(分别为P<0.05,P<0.01);(5)Logistic多因素分析显示,年龄、病程、OGTT空腹以及餐后2小时血糖、尿A/C与糖尿病周围神经变呈显著正相关,而空腹以及OGTT餐后2小时的胰岛素和C肽水平与糖尿病神经病变呈显著负相关。结论:年龄、病程、HbA1c、尿A/C、空腹以及餐后2小时的血糖、胰岛素、C肽是糖尿病神经病变的危险因素。其中年龄、病程、空腹以及2小时血糖、尿A/C与糖尿病周围神经变呈显著正相关,空腹以及餐后2小时胰岛素和C肽水平与糖尿病神经病变呈显著负相关。更多还原

【Abstract】 Objective:To study the risk factors in the patients with type 2 diabetic peripheral neuropathy.Methords:565 type 2 diabetic patients were tested for the nerve conduction velocity.The patients were divided into diabetic peripheral neuropathy group and non-diabetic peripheral neuropathy group.Blood pressure,triglyerides(TG),total cholesterol(TC),HDL-C,LDL-C,body mass index(BMI),glycosylated henogbbin(HbAlc),insulin,C peptide and urinary albumm/creatinine(A/C)were measured for all patients.All the risk factors were included in the statistical analysis.Results:Duration of diabetes,age,fasting plasma glucose,2-hour plasma glucose,TG,TC,urinary A/C and HbAlc in diabetic peripheral neuropathy group were significantly higher than that in nondiabetic peripheral neuropathy group.The level of fasting insulin and and plasma C peptide postprandial 2-hour insulin and plasma C peptide were significantly lower than that in non-diabetic peripheral neuropathy group.Conclusion:By logistic regression analysis,it was found that the significant risk factors of diabetic peripheral neuropathy in type 2 diabetic patients were age,duration of diabetes,HbAlc,urinary A/C,fasting and postprandial 2-hour glucose,C peptide and insulin.更多还原