【作者】 曹瑛； 薛耀明； 杨群英； 高方； 谢翠华； 李际敏； 付霞军； 朱波；

【Author】 Ying Cao;Yaoming Xue;Qunying Yang;Fang Gao;Cuihua Xie;Jimin Li;Xiajun Fu;Bo Zhu;Endocrinology of Nan Fang Hospital Southern Medical University;

【机构】 广州南方医科大学南方医院内分泌代谢科；

【摘要】 目的:探讨2型糖尿病患者足部痛、温、触觉、震动觉、泌汗神经病变及踝壁指数的流行病学分布状况。方法:收集广州南方医科大学南方医院近3年出院2型糖尿病病历中含有完整足部痛、温、触、震动、泌汗神经功能及踝壁指数(ABI)检查患者的临床资料,分析流行病学及其相关因素。结果:共搜集资料完整病例2681例,占同期出院2型糖尿病患者的71.2%。平均年龄56.2±12.3岁,其中男性1539例,占57.4%,女性1142例,占42.6%。按照20~40岁、40~50岁、50~60岁、60~70岁、70~以上,五个年龄段划分显示分别为:痛觉异常率41.5%、56.5%、72.2%、78.7%、83.4%(P﹤0.05);温度觉异常率12.8%、17.1%、30.3%、44.8%、61.9%(P﹤0.05);触觉异常率20.4%、50.86%、.49.9%、67.1%、75.6%(P﹤0.05);震动觉异常率1.1%/、3.47%、5.25%、10.8%、41.9%(P ﹤0.05)。泌汗功能异常率69.2%、69.9%、90.8%、94.6%、97.2%(P﹤0.05);ABI.异常率1.4%、3.05%、5.42%、16.7%、38.1%(P﹤0.05);按照病史划分为新诊断、1~5年、5~10年、10~20年四个阶段,相应的痛觉异常率分别为56.7%、63.6%、75.6%、73.9%(P﹤0.05);温度觉异常率24.8%、28.8%、44.6%、50.5%(P﹤0.05);触觉异常率分别为36.1%、48.3%、67.2%、67.8%(P﹤0.05);震动觉异常率0.8%、4.16%.、13.6%、17.0%(P﹤0.05);泌汗功能异常率74.0%、84.3%、93.5%、94.3%(P﹤0.05);ABI异常率4.13%、11.7%、16.8%、29.2%(P﹤0.05)。痛、温、触、震动、自主神经病变发生率与年龄及病程呈正相关(P﹤0.05),与HbA1c、CHOL、SBP、BMI均无明显相关关系(P﹥0.05)。ABI异常率与病程、年龄、SBP呈完全正相关关系(P﹤0.05),与HbA1c、CHOL无明显相关关系(P﹥0.05)。结论:2型糖尿病患者周围神经病变及下肢动脉病流行趋势严峻,初发患者具高患病率,年龄和病程是影响患病率的两个最主要因素。.更多还原

【Abstract】 Objective: To investigate the epidemiological distribution of type 2 diabetes patients pain sense, temperature sense, tactual sense, vibration sense, sudomotor nerves pathologic changes and ABI.Method: We collect the complete clinical datas from type 2 diabetes patients`s pain sense, temperature sense, tactual sense, vibration sense, sudomotor nerves functions and ABI. They have been cured in Guangzhou Southern Medical University Affiliated South Hospital and left in the last three years,And we study their sudomotor nerves function and ABI thus analyzing its epidemiology and related factors.Results: We have colletced complete datas from a total of 2681 cases,accounting for 71.2% of the Type 2 diabetes cases who left hospital over the same period.The average age is 56.2±12.3years old.There are 1539 male cases, accounting for 57.4%,1142 female cases,42.6%.According to ages,they are divided into the following 5 g roups:20~40ys,40~50ys,50~60ys,60~70ys,70 ys above.Results are as follows:Abnormal rates of pain sense are 41.5%、56.5%、72.2%、78.7%、83.4%(P<0.05)respectively;Abnormal rates of temperature sense are 12.8%、17.1%、30.3%、44.8%、61.9%(P<0.05)respectively; Abnormal rates of tactual sense are 20.4%、50.86%、 49.9%、67.1%、75.6%(P<0.05)respectively; Abnormal rates of vibration sense are 1.1%/、3.47%、5.25%、10.8%、41.9%(P<0.05)respectively;Abnormal rates of sudomotor nerves function are 69.2%、69.9%、90.8%、94.6%、97.2%(P<0.05)respectively; Abnormal rates of ABI are 1.4%、3.05%、5.42%、16.7%、38.1%(P<0.05)respectively; According to disease history,they are divided into the following 4 groups :newly diagnosed,1~5ys diagnosed,5~10ys diagnosed,10~20ys diagnosed.and the corresponding abnormal rates of pain sense are56.7%、63.6%、75.6%、73.9%(P<0.05)respectively;Abnormal rates of temperature sense are 24.8%、28.8%、44.6%、50.5%(P<0.05)respectively; Abnormal rates of tactual sense are36.1%、48.3%、67.2%、67.8%(P<0.05)respectively; Abnormal rates of vibration sense are0.8%、4.16% 、13.6%、17.0%(P<0.05)respectively; Abnormal rates of sudomotor nerves function are 74.0%、84.3%、93.5%、94.3%(P<0.05)respectively; Abnormal rates of ABI are 4.13%、11.7%、16.8%、29.2%(P<0.05)respectively; The pain sense, temperature sense, tactual sense, vibration sense, autonomic neuropathy pathologic changes rates are positive correlated to patients’ ages and courses of diseases(P<0.05),not evidently correlated to HbA1c、CHOL、SBP、BMI(P>0.05).Abnormal rates of ABI are completely positive correlated to courses of disease,ages,SBP(P<0.05),but not HbA1c、CHOL(P>0.05).Conclusion: Type 2 diabetes patients’ peripheral nerve pathologic changes and lower artery disease becomes severe. Patients in primary phase are with a high morbidity.The two main factors which affect morbidity are age and course of disease.更多还原