2型糖尿病患者并发糖尿病周围神经病变危险因素分析  

Risk Factor for Type 2 Diabetes Mellitus Complicated With Diabetic Peripheral Neuropathy

作　　者：唐键[1,2] 王博[1,2] 张玄娥[1,2] 程笑冰[1,2] 唐文佳[1,2] 顾蕾[1,2] 周尊海[1,2] 

机构地区：[1]同济大学附属杨浦医院内分泌科 [2]同济医学院全科医学系,上海市200090

出　　处：《中国全科医学》2015年第30期3657-3661,共5页Chinese General Practice

摘　　要：目的探讨2型糖尿病(T2DM)并发糖尿病周围神经病变(DPN)的危险因素。方法选取2014年6—9月同济大学附属杨浦医院确诊的T2DM患者282例,并发DPN患者170例(DPN组),未并发DPN患者112例(对照组),比较两组患者临床资料、实验室检查指标及震动阈值、踝臂指数(ABI),T2DM并发DPN影响因素分析采用多因素Logistic回归分析方法。结果对照组与DPN组患者性别、视物模糊发生率、手足麻木发生率、吸烟率、身高、体质量、体质指数(BMI)、腰围、臀围、舒张压、脉搏、尿微量清蛋白、空腹血糖、空腹C肽、餐后2 h C肽、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、天冬氨酸氨基转移酶(AST)、血钾、血钠、血钙水平、右侧ABI、左侧ABI比较,差异均无统计学意义(P>0.05)。DPN组患者年龄、高血压发生率、冠心病发生率、脑梗死发生率、糖尿病病程、收缩压、糖化血红蛋白(Hb A1c)、餐后2 h血糖、肌酐、尿素氮(BUN)、同型半胱氨酸水平、右侧震动阈值、左侧震动阈值均高于对照组(P<0.05);DPN组患者饮酒率、丙氨酸氨基转移酶(ALT)、清蛋白水平低于对照组(P<0.05)。多因素Logistic回归分析结果显示,年龄、吸烟、饮酒、糖尿病病程与T2DM并发DPN有回归关系(P<0.05)。结论 T2DM并发DPN患者糖尿病病程较长,吸烟会加重DPN的病情。Objective To investigate the risk factors for type 2 diabetes mellitus（ T2DM） and diabetic peripheral neuropathy（ DPN）. Methods We enrolled 282 patients who were definitely diagnosed with T2 DM in Yangpu Hospital Affiliated to Tongji University from June to September in 2014. Among the subjects,170 patients（ DPN group） were complicated with DPN, and 112 patients（ control group） had no DPN. Comparison was made between the two groups in clinical data,laboratory examination indexes, vibration perception threshold（ VPT） and ABI. Multivariate Logistic regression analysis was conducted to explore the influencing factors for T2 DM complicated with DPN. Results The two groups were not significantly different（ P〈0. 05） in gender,the incidence of blurred vision,the incidence of numbness in hands and feet,smoking rate,height,body weight, BMI, waistline, hipline, DBP, pulse, microalbuminuria, FBG, fasting plasma C- peptide,postprandial 2 h C peptide,TC,TG,HDL- C,LDL- C,AST,serum potassium,serum sodium,blood calcium,right ABI and left ABI. DPN group was higher（ P〈0. 05） than control group in age,the incidence rates of hypertension,coronary heart disease and cerebral infarction, duration of diabetes, SBP, glycosylated hemoglobin, 2 h PBG, creatinine, BUN,homocysteine level,right VPT and left VPT; DPN group was lower（ P〈0. 05） than control group in the rate of alcohol use and ALT,albumin level. Multivariate Logistic regression analysis showed that age,smoking,alcohol use,duration of diabetes have regression relation with T2 DM complicated with DPN（ P〈0. 05）. Conclusion T2 DM patients complicated with DPN have longer T2 DM duration. Smoking use may aggregate DPN.

关 键 词：糖尿病 2型 糖尿病神经病变 危险因素 

分 类 号：R587.1[医药卫生—内分泌]