2型糖尿病患者周围神经病变相关危险因素分析  

Analysis of the related risk factors of peripheral neuropathy in type 2 diabetic patients

作　　者：常琦[1] 吴元波[1] 任明山[1] 吴元洁[2] 叶山东[3] 杨光伟[3] 

机构地区：[1]安徽医科大学附属省立医院神经内科,230001 [2]安徽中医药大学中医基础教研室,230038 [3]安徽医科大学附属省立医院内分泌科,230001

出　　处：《中国神经免疫学和神经病学杂志》2015年第5期342-346,共5页Chinese Journal of Neuroimmunology and Neurology

基　　金：国家自然科学基金资助项目(81102626H2716)

摘　　要：目的探讨2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)相关危险因素。方法回顾性分析710例2型糖尿病住院患者的病史资料,采用震动感觉阈值(vibration perception threshold,VPT)评估DPN病情严重程度,根据VPT评分将DPN严重程度分为轻、中、重3组,分别与无DPN组比较临床特征、血生化及常规指标等的差异;采用Ordinal回归分析探讨DPN发生的危险因素。结果本组资料DPN的总发生率为57.2%,其中轻、中、重度3组患者DPN的发生率分别为22.4%、21.0%、13.8%。病程、体重指数(BMI)、糖化血红蛋白(HbAlc)、血清丙氨酸氨基转移酶(ALT)、天氡氨酸氨基转移酶(AST)、红细胞体积分布宽度(RDW-CV)、平均红细胞血红蛋白浓度(MCHC)、糖尿病视网膜病变(DR)发生率、外周动脉疾病(PAD)发生率在轻、中、重度DPN组和无DPN组间比较差异有统计学意义(均P<0.05)。Ordinal回归分析显示病程、HbAlc、BMI、AST、RDW-CV、DR、PAD为DPN发生的影响因素(均P<0.05)。结论病程、HbAlc、BMI、AST、RDW-CV、并发PAD及并发DR可能是DPN发生的危险因素。Objective To investigate the related risk factors of type 2 diabetic peripheral neuropathy （DPN） . Methods The data of the in-patients with type 2 diabetes were retrospectively studied. Vibration perception threshold （VPT） was adopted to assess the severity of DPN among a total of 710 type 2 diabetic patients. Based on VPT scores, the diabetic patients were divided into mild, moderate and severe groups. The clinical features, blood routine and blood biochemistry indices were analyzed according to the severity of DPN. Ordinal regression analysis was applied to explore the risk factors for the development of DPN. Results The overall incidence of DPN in this study was 57.2%, among which the mild, moderate and severe groups respectively accounted for 22.4%, 21.0% and 13.8%. There were significant differences of the age, course of disease, body mass index （BMI）, glycosylated hemoglobin （ HbAle）, Manine aminotransferase （ ALT）, aspartate transaminase （AST）, mean corpuscular hemoglobin concentration （MCHC）, red blood cell volume distribution width （RDW-CV）, coincidences of diabetic retinopathy （DR） and peripheral arterial disease （PAD） among the mild, moderate, severe and non-DPN groups （P〈0.05, respectively）. Ordinal regression analysis indicated that the course of disease, HbAlc, BMI, AST, RDW-CV, DR and PAD might be the risk factors of DPN （P〈0.05）. Conclusions Course of disease, HbAlc, BMI, AST, RDW-CV, DR and PAD could be the risk factors for the development of DPN.

关 键 词：糖尿病 2型 糖尿病并发症 震动感觉阈值 危险因素 

分 类 号：R745.49[医药卫生—神经病学与精神病学]