两种降糖方式对糖尿病周围神经病患者F波的影响及意义  

Effects of different hypoglycemic treatment on F wave of diabetic peripheral neuropathy patients

作　　者：孙丽艳[1] 赵蒙[1] 殷宏宇[1] 王为[1] 孙庆权 王丹[1] 

机构地区：[1]大连大学附属新华医院,辽宁大连116021

出　　处：《中国实验诊断学》2017年第5期810-813,共4页Chinese Journal of Laboratory Diagnosis

基　　金：大连市卫计委课题(2015-109)

摘　　要：目的通过F波的参数分析单纯口服降糖治疗与多次胰岛素皮下注射联合口服降糖治疗对糖尿病周围神经病(diabetic peripheral neuropathy,DPN)的影响及临床意义。方法收集糖尿病周围神经病患者121例,男51例,女70例,平均年龄(62.22±9.03)岁;平均病程(115.21±84.40)月。根据治疗方式不同分为两组,口服治疗组(OHA组),每日多次胰岛素皮下注射联合口服降糖治疗组(MDSⅡ+OHA组)。根据糖化血红蛋白(hemoglobin,HbA1c)水平不同分为HbA1c>8%组和HbA1c≤8%组。采用肌电图诱发电位仪进行胫神经的F波检测及神经传导检测,记录各参数并进行比较。结果与OHA组比较,MDSⅡ+OHA组的HbA1c水平较低(P<0.05),空腹血糖(fast blood glucose,FPG)水平无差别(P>0.05)。MDSⅡ+OHA组Fmin、Fmax、Fmean及SCV均缩短,差异有显著意义(P<0.05)。与HbA1c>8%组比较,HbA1c≤8%组的Fmin、Fmax、Fmean、S-LAT均缩短(P<0.05),S-MAP、SCV无显著差异(P>0.05)。结论与单纯口服降糖药物治疗相比,间断胰岛素皮下注射联合口服降糖药治疗可能更好的延缓DPN患者周围神经的损害;有效的控制血糖可能更好的减轻糖尿病的周围神经损害;F波可能更早地反映DPN的神经损伤,F波的参数反映DPN损伤可能较神经传导速度检测更敏感。Objective To investigate the effect of different hypoglyeemic treatment on diabetic peripheral neuropathy （DPN） patients by the means of F wave. Methods a total of 121 patients with diabetic peripheral neuropathy were enrolled in this study,among them 51 were males and 70 were females,with an average age of 62.22 ：J： 9.03 years, and the average DM duration was 115.21±84.40. The patients were divided into two groups according to the different hypoglycemic treatment methods,oral hypoglycemic agents （OHA）group , multiple subcutaneous insulin injection combined with oral hypoglycemic treatment （MDS ＋ OHA） group. According to the hemoglobin （HbA1c） levels , all the patients were divided into two group：one group with HbA1c ≤8% ,and the other group with HbAlc 〉 8% group. The nerve conduction test and F wave detection of tibial nerve were detected by neurophysiological detection. Results compared with OHA group,the level of HbAlc in MDS II ＋OHA group was lower （P〈0.05） ,and The Fmin,Fmax, Fmean and SCV of MDS ＋OHA group were shortened, （P〈0.05）. there was no difference of fasting blood glucose in two group, （P〉0.05）. Compared with the group that HbA1c 〉 8% ,the Fmin,Fmax,Fmean,S-LAT was shortened in the group that HbA1c≤ 8%, （P〈0. 05）, S-MAP and SCV had no significant difference （P〉0. 05） between two group. Conclusion compared with simple oral hypoglycemic drugs,subcutaneous injection of insulin combined may better delay peripheral nerve injury of DPN patients;The better glucose control may effectively relieve diabetic peripheral nerve damage;F wave may reflect the nerve damage of DPN earlier and more sensitive than nerve conduction studies.

关 键 词：糖尿病 周围神经病 降糖治疗 F波 神经传导速度检测 

分 类 号：R587.2[医药卫生—内分泌]