糖尿病周围神经病变患病率及危险因素分析  

Prevalence and risk factors of diabetic peripheral neuropathy

作　　者：陈晓倩[1,2] 毕艳[3] 胡云[3] 童国玉 朱大龙[1] 

机构地区：[1]南京医科大学鼓楼临床学院,南京医学硕士研究生210008 [2]南京市市级机关医院 [3]南京大学医学院附属鼓楼医院内分泌科,南京210008

出　　处：《医学研究生学报》2011年第10期35-38,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金(30800539);江苏省自然科学基金(BK2010110)

摘　　要：目的糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)是一种发生较早的常见慢性糖尿病并发症,不但可引起糖尿病患者的病死率和致残率升高,带来复杂的护理、医疗问题,也是造成糖尿病患者反复住院的主要原因。其发病机制尚未完全明确,推测与多种因素有关。文中调查江苏省2型糖尿病人群中DPN的患病情况,并探讨2型糖尿病DPN患病的危险因素。方法采用多阶段、分层抽样的方法调查江苏省56个研究中心的门诊2型糖尿病患者,通过回顾病例、门诊访谈,收集患者人口学资料、糖尿病类型及相关治疗、并发症等资料,并采集血样统一进行糖化血红蛋白检测。根据糖尿病神经病变筛查结果分为DPN组和非DPN组,计算2型糖尿病人群中DPN的患病率,用Logistic多元回归分析周围神经病变的危险因素。结果 2型糖尿病患者中,DPN患病率为44.1%。DPN组年龄、糖尿病病程、糖化血红蛋白、空腹血糖、餐后血糖、腰臀比、收缩压均显著高于非DPN组(P<0.01);女性、有高血压病史,运动不规律、低收入(<2000元/月)以及大学以下文化程度者DPN患病率明显高于男性、无高血压病史、规律运动、高收入以及大学以上学历者。Logistic多元回归分析显示,女性、年龄、腰臀比、糖尿病病程、糖化血红蛋白、餐后血糖与DPN患病呈正相关,收入与DPN呈负相关。结论外周神经病变在2型糖尿病患者中较为常见。年龄、性别、腰臀比、糖尿病病程、糖化血红蛋白、餐后血糖以及低收入为DPN的危险因素。Objective Diabetic peripheral neuropathy(DPN) is the most common and one of the earliest chronic complications of diabetes.It not only associates with increasing mortality and mutilation rate,but also complicates nursing and medical care problems,which are the primary causes for repeated hospitalizations in patients with diabetes.The pathomechanism of DPN remains poorly understood,however,it has been established that multifactors contribute to the development of DPN.This study is to analyze the prevalence of DPN and its risk factors among type 2 diabetes mellitus(DM) in Jiangsu Province,China.Methods This study applied a multiple-stage,stratified sampling method to select a representative sample of the type 2 DM patients in out-patient population in 56 research centers in Jiangsu Province.The demographic data,diabetes type and related therapies and complications of targeted patients were collected via case review and clinic interview.Blood samples were collected and sent to central lab s for glycosylated hemoglobin test.The morbidity rate of DPN in patients with type 2 DM was calculated.The patients were divided into 2 groups according to the screening results: DPN group(n=1308) and non-DPN group(n=1658).The risk factors were subject to multiple logistic regression.Results The overall DPN prevalence in patients with type 2 DM of Jiangsu Province was 44.1%.The values of age,duration of diabetes,HbA1c,fasting plasma glucose,postprandial plasma glucose,waist/hip ratio,and systolic blood pressure in the DPN group were significantly higher than those in the non-DPN group.Multiple logistic regression analysis revealed that female and the values of age,waist/hip ratio,duration of diabetes,HbA1c and postprandial plasma glucose were positively correlated with DPN prevalence,and the value of income was negatively correlated with DPN prevalence.Conclusion The prevalence of DPN is common in type 2 diabetic patients.Age,gender,waist/hip ratio,the duration of diabetes,HbA1c,postprandial blood glucose and low-income were risk f

关 键 词：2型糖尿病 糖尿病周围神经病变 患病率 危险因素 

分 类 号：R58[医药卫生—内分泌]