维生素D缺乏与糖尿病周围神经病变的关系及对硫辛酸疗效的影响  

作　　者：傅莉萍[1] 王保法[1] 朱岚[1] 金剑虹[1] 

机构地区：[1]杭州市中医院,310006

出　　处：《浙江临床医学》2020年第2期233-235,共3页Zhejiang Clinical Medical Journal

基　　金：杭州市科技计划基金项目(2015KJJ18)。

摘　　要：目的为了探讨维生素D缺乏与2型糖尿病周围神经病变(DPN)的关系及对硫辛酸治疗神经病变疗效的影响.方法选取2型糖尿病患者312例,按照DNP诊断标准分为DPN组(200例)和非DPN组(112例).收集临床资料,测定糖化血红蛋白(HbA1c)、生化指标和25(OH)维生素D[25(OH)D]水平.分析25(OH)D与各指标之间的相关性.DPN组在常规治疗基础上给予硫辛酸注射液600mg/d,静脉滴注14d,根据是否存在维生素D缺乏,分为维生素D缺乏组和维生素D非缺乏组,比较两组治疗前后的神经传导速度检测数据.结果DPN组的25(OH)D水平平均为(14.27±4.45)μg/L明显低于非DPN组(18.57±7.23)μg/L(P=0.013),在DPN组25(OH)D缺乏的患者比例达到了84%,明显高于非DPN组的64.3%,两组有统计学差异.25(OH)D水平与病程、HbA1c、LDL-C水平呈负相关.维生素D缺乏组和维生素D非缺乏组患者经硫辛酸治疗后神经传导速度均较治疗前明显改善,而且维生素D非缺乏组较维生素D缺乏组神经传导速度改善更明显(P<0.05),结论维生素D缺乏与DPN相关,并影响硫辛酸治疗DPN的疗效.Objective To explore the correlation between vitamin D deficiency and diabetic peripheral neuropathy(DPN)in type 2 diabetes mellitus(T2DM)and its effect on the curative effect of Iipoic acid on DPN.Methods A total of 312 patients with T2DM were enrolled and divided into DPN group(n=200)and non—DPN group(n=112).Clinical data was collected and serum levels of 25—hydroxy vitamin D[25(OH)D],glycosylated hemoglobin(HbAlc),biochemical indexes were determined in aU patients.Correlation analysis between 25(OH)D and other indicators were performed.DPN group received intravenous drip of lipoic acid 600mg/d for 14 days on the basis of control group therapy.The DPN patients were divided into vitamin D deficiency group and non—vitamin D deficiency group according to the level of serum 25(OH)D.The nerve conduction test data were compared between the two groups.Results The serum 25(OH)D level was significantly lower in the patients with DPN(14.27±4.45)μg/L than that of the patients without DPN(18.57±7.23)μg/L(P=0.013).Vitamin D deficiency was found in 84%of DPN group and in 64.3% of non—DPN group with statistical significant differences(P=O.001).There existed a negative correlation between the level of 25(OH)D and duration of T2DM,HbAlc and LDL—C.After lipoic acid treatment,the motor and sensory nerve conduction velocities in vitamin D deficiency and non—vitamin D deficiency groups were significantly improved,and the improvement in the non—vitamin D deficiency group was much more than in the vitamin D deficiency group(P<0.05).Conclusion Vitamin D deficiency is related to DPN and may weaken the curative effect of lipoic acid on DPN.

关 键 词：维生素D 糖尿病周围神经病变 2型糖尿病 硫辛酸 

分 类 号：R58[医药卫生—内分泌]