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作 者:周怡昆[1] 薛元明[1] 张永红[1] 赵仁华[1] 苏恒[1] 马杉[1] 牛奔[1]
机构地区:[1]云南省第一人民医院(昆明医学院附属昆华医院)内分泌代谢科,昆明650032
出 处:《中华内分泌代谢杂志》2009年第6期601-603,共3页Chinese Journal of Endocrinology and Metabolism
摘 要:目的研究2型糖尿病足部振动感觉损伤相关危险因素。方法用振动感觉分析仪对3270名2型糖尿病患者行振动感觉检查,分为振动感觉减退的研究组及无振动感觉减退的对照组,测定尿蛋白、血脂、体重指数、血糖、HbA1c、血清果糖胺、C肽、血压等及眼底检查。结果研究组年龄平均为(59±12)岁,病程≥5年、24h尿蛋白定量≥300mg/d、有糖尿病视网膜病变、足部症状及男性比例均高于对照组,空腹血清C肽(0.56±0.45)nmol/L、餐后2hC肽(1.81±0.95)nmol/L均低于对照组[(0.65±0.56)和(2.14±0.82)nmol/L,P〈0.05]。Logistic回归分析显示,足部症状、24h尿蛋白定量、糖尿病病程与振动感觉减退明显相关。结论24h尿蛋白量、糖尿病病程、足部症状是2型糖尿病振动感觉损伤的危险因素。Objective To study the risk factors of decreased feet vibration perception in type 2 diabetic patients. Methods Three thousand two hundred and seventy patients with type 2 diabetes were divided into 2 groups according to the results of vibration perception test : group A with decreased vibration perception and grnup B with normal perception as control. Urinary protein content, lipid profile, body mass index, blood glucose, HbA, c, plasma fructosamine, C-peptide, and blood pressure were measured, and ocular fundus were examined. Results The subjects in group A were older than those in group B [ (59± 12) vs (56±12) years,P〈0.05 ]. The percentage of longer diabetes duration ( ≥5 years) ,24 h urinary protein content ≥300 mg/d, combined diabetic retinopathy, foot symptoms and male sex were higher in group A than those in group B. Fasting and postprandial C- peptide levels [ ( 0.56±0.45 and 1.81 ±0.95 ) nmol/L] in group A were lower than those in group B [ (0.65±0.56 and 2.14±0. 82) nmol/L, P〈0. 05 ]. Logistic regression analysis showed that the independent risk factors of decreased feet vibration perception in type 2 diabetic patients were 24 h urinary protein, foot symptoms and duration of diabetes. Conclusion 24 h urinary protein content,duration of diabetes, and foot symptoms seem to be the most important risk factors related to decreased vibration perception in type 2 diabetes.
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