甲钴胺对糖尿病周围神经病变患者血浆同型半胱氨酸的影响  

Effect of mecobalamine on the plasma homocysteine level in diabetic periphe-ral neuropathy patients

作　　者：侯代玉[1] 徐莹[1] 李洁[2] 林范珍[1] 董霞[1] 

机构地区：[1]哈尔滨医科大学附属第一医院内分泌科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第一医院血液科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2012年第5期455-458,共4页Journal of Harbin Medical University

摘　　要：目的观察同型半胱氨酸(homocysteine,Hcy)在糖尿病周围神经病变(diabetic peripheral neu-ropathy,DPN)患者血浆中的水平及甲钴胺干预后变化。方法将130例2型糖尿病患者分为两组,有DPN组(DPN+组)和无DPN组(DPN-组),30例健康者为正常对照组,检测血浆Hcy水平。将DPN+组中高Hcy患者随机分为两个亚组:甲钴胺治疗组和空白对照组,甲钴胺治疗组给予甲钴胺(500μg/d)肌注,空白对照组不给予干预治疗,2周后比较两个亚组Hcy水平,并通过临床和电生理方法评估神经病变的改善程度。结果 DPN+组中高Hcy血症患者占67.8%,其Hcy水平明显高于DPN-组和正常对照组(P<0.05)。经甲钴胺治疗可以明显降低患者血浆Hcy水平(P<0.05),神经病变症状和神经传导速度也较空白对照组有明显改善(P<0.05)。结论 Hcy为DPN的危险因素,甲钴胺干预后可降低患者血浆Hcy水平,改善患者神经病变的症状。Objective To observe homocysteine（Hcy） level in diabetic peripheral neuropathy（DPN） patients＇ plasma and the intervention effect on it by mecobalamine.Methods One hundred and thirty patients of type 2 diabetes mellitus（DM） were divided into two groups： one group with DPN（DPN＋）,and one group without DPN（DPN-）,and 30 cases of normal control were enrolled,both for the detection of the level of plasma Hcy.The cases of type 2 DM DPN＋ plus hyperhomocysteinemia were randomly divided into two subgroups： medical intervention group and blank control group.Medical intervention group was treated with mecobalamine injection（500 μg/d）,blank control group was not given intervention treatment.Two weeks later,Hcy level was measured,and neuropathy improvement degree was evaluated by clinical and electrobiological methods.Results The hyperhomocysteinemia morbidity in DPN＋ was 67.8%,and the Hcy level was higher than DPN-and normal control（P0.05）.Compared with the blank control group,the levels of Hcy in group of mecobalamine intervention was lower（P0.05）,and neuropathy symptoms and nerve conduction velocity was also obviously improved（P0.05）.Conclusions Hcy is a risk factor for DPN.Treatment with mecobalamine can lower the plasma Hcy level,and improve symptoms of neuropathy patients.

关 键 词：糖尿病周围神经病变 同型半胱氨酸 甲钴胺 

分 类 号：R587.2[医药卫生—内分泌] R977.22[医药卫生—内科学]