2型糖尿病周围神经病变与胰岛β细胞功能的相关分析  

作　　者：余绮玲[1] 梁伟[1] 

机构地区：[1]广州市第一人民医院内分泌科,510180

出　　处：《中国社区医师（医学专业）》2010年第34期167-168,共2页

摘　　要：目的:分析2型糖尿病患者中胰岛β细胞功能和周围神经病变的相关关系。方法:回顾性分析310例2型糖尿病患者胰岛β细胞功能减退组与对照组间周围神经病变患病率的差异,并分析2型糖尿病周围神经病变的危险因素。结果:胰岛β细胞功能减退组中VPT>10mV的患者占66.7%,NSS评分>1的患者占52.1%,明显高于对照组(P<0.05);而ABI异常的发生率两组间差异无显著性(P>0.05)。多因素Logsitic多元回归分析纠正血糖、血压、病程等混杂因素后显示空腹C肽水平是DPN的独立危险因素(R2=-0.29,P=0.02)。结论:2型糖尿病患者中保护残存胰岛细胞β功能对糖尿病周围神经病变的发生有独立于降糖外保护作用;对于空腹C肽水平低下的2型糖尿病患者定期进行振动感觉阈值检查(VPT)有助于周围神经病变的早期诊断。Objective： Our aim was to retrospectively evaluate the association of pancreatic β - cell function with neuropathy. Methods ：We recruited a clinic -based cohort of 310 type 2 diabetic patients,Routine measurements and ascertainment of neuropathy were employed. The prevalence of neuropathy was compared between different β - cell secretion groups. RESULTS：the ratio of patients with abnormal VPT （ 66. 7% ） and NSS （52. 1% ）In lower β -cell function group was higher than control group （P 〈 0. 05 ）, while no significant differences of ABI was observed between two groups （ P 〉 0. 05）. In logistic regression analysis, fasting plasma C - peptide values were negtively associated with diabetic neuropathy （R2 = - 0. 29 ; P = 0.02） independently of age, diabetes duration, blood pressure. Conclusions：Our study shows an independent protective effect of residual β - cell function on the development of neuropathy in type 2 dia-betes, and it is helpful to early diagnose di- abetic neuropathy that type 2 diabetics accept the measurement of VPT every year, particularly those patients with low fasting c peptide level.

关 键 词：2型糖尿病 周围神经病变 振动感觉阈值 踝臂指数 Β细胞功能 

分 类 号：R587.2[医药卫生—内分泌]