进展性肝纤维化与2型糖尿病周围神经病变的关系  

The relationship between progressive liver fibrosis and diabetic neuropathy

作　　者：谢春晓[1] 贾国瑜[2] 王璐[2] 李强[2] 王绍程 杨玲[1] 邸阜生[2] 

机构地区：[1]天津医科大学三中心临床学院,300170 [2]天津市第三中心医院,天津市人工细胞重点实验室

出　　处：《天津医药》2016年第3期345-348,共4页Tianjin Medical Journal

基　　金：天津市应用基础与前沿技术研究计划项目(15JCYBJC27700)

摘　　要：目的研究进展性肝纤维化与2型糖尿病周围神经病变(DPN)之间的关系。方法选取近3年(2013年2月—2015年2月)在天津市第三中心医院住院的2型糖尿病(T2DM)患者173例(男89例,女84例),根据非酒精性脂肪性肝病纤维化评分(NFS)分为3组:A组(NFS≤-1.455)49例,B组(-1.455<NFS<0.676)95例,C组(NFS≥0.676)29例。比较3组DPN、感觉神经病变(SNCA)和运动神经病变(MNCA)的发生率,并分析3种疾病的影响因素。DPN、SNCA和MNCA由神经电图确诊,肝纤维化严重程度由NFS确定。结果 A、B、C组患者DPN、SNCA、MNCA的发生率分别为69.4%、78.9%、86.2%,65.3%、73.7%、86.2%和38.8%、49.5%、65.5%,组间差异均无统计学意义。Logistic回归分析示高NFS为DPN、SNCA、MNCA的独立危险因素。结论非酒精性脂肪性肝病导致的肝纤维化与DPN发生率的增加有关,高NFS是导致T2DM患者发生DPN、SNCA、MNCA的独立危险因素。Objective To study the relationship between advanced liver fibrosis and peripheral neuropathy in patientswith type 2 diabetes mellitus（DPN）. Methods A total of 173 patients（89 men and 84 women） with type 2 diabetes who hos-pitalized in Tianjin Third Central Hospital within nearly three years（2013.02-2015.02） were divided into three groups ac-cording to non-alcoholic fatty liver disease（NAFLD） fibrosis score： group A（NFS≤-1.455）, group B（-1.455NFS0.676）and group C（NFS≥0.676）. The prevalence of DPN, sensory nerve conduction abnormalities（SNCA）, motor nerve conductionabnormalities（MNCA） were compared, and the influencing factors were analysis between three groups. DPN, MNCA and SN-CA were ascertained by electroneurogram, and the severity of liver fibrosis was ascertained by NAFLD fibrosis score. Results The prevalence rates of DPN, SNCA and MNCA were 69.4%, 78.9%, 86.2%, 65.3%, 73.7%, 86.2%, 38.8%, 49.5%and 65.5% in group A, group B and group C. There was no significant statistical difference between the three groups. Logisticregression analysis indicated that high NFS was an independent risk factor of DPN, SNCA and MNCA. Conclusion NAFLDfibrosis has a relationship with the prevalence rate of DPN, which is an independent risk factor of DPN, SNCA and MNCA inpatients with T2DM.

关 键 词：糖尿病 2型 脂肪肝 糖尿病神经病变 非酒精性脂肪性肝病 进展性肝纤维化 肝脂含量 糖尿病周围神经病变 

分 类 号：R575.2[医药卫生—消化系统] R587.25[医药卫生—内科学]