糖尿病周围神经病变炎症因子变化及与神经传导速度相关性  

Changes of inflammatory factors in diabetic peripheral neuropathy and their correlation with nerve conduction velocity

作　　者：张桐毓 杨传慧 徐宁[1] ZHANG Tong-yu;YANG Chuan-hui;XU Ning(Department of Endocrinology,the First People′s Hospital of Lianyungang City,Jiangsu Province,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市第一人民医院内分泌科,江苏连云港222000

出　　处：《河北医科大学学报》2023年第5期517-520,571,共5页Journal of Hebei Medical University

基　　金：江苏省自然科学基金项目(BK20190808)。

摘　　要：目的分析糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)炎症因子变化及与神经传导速度相关性。方法选取连云港市第一人民医院收治的2型糖尿病(type 2 diabetes mellitus,T2DM)患者114例,依据密歇根神经病变筛查表将患者分为T2DM组(34例)和DPN组(80例)。收集患者的一般资料,检测血糖相关指标[空腹血糖(fasting blood sugar,FPG)、餐后2 h血糖(2 h postprandial blood glucose,2 hPG)、糖化血红蛋白(glycated hemoglobin,HbA_(1)c)]、炎症因子[肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素1β(interleukin-1β,IL-1β)、白细胞介素10(interleukin-10,IL-10)、巨噬细胞炎症蛋白1(macrophage inflammatory protein-1,MIP-1)]、神经传导速度(正中神经、腓神经的运动和感觉传导速度)。比较两组患者的一般资料及炎症因子、神经传导速度;分析炎症因子与神经传导速度的相关性及神经传导异常的影响因素。结果DPN组病程、FPG、2 hPG、HbA_(1)c、TNF-α、MIP-1α高于T2DM组,IL-1β、IL-10、正中神经、腓神经的运动、感觉传导速度低于T2DM组(P<0.05)。IL-1β与正中神经、腓神经运动和感觉传导速度成正相关(P<0.05);TNF-α、MIP-1α分别与正中神经、腓神经运动和感觉传导速度呈负相关(P<0.05)。病程、HbA_(1)c、TNF-α为正中神经运动传导速度的影响因素(P<0.05),年龄、TNF-α、HbA_(1)c为正中神经传导异常和腓神经传导异常的影响因素(P<0.05)。结论DPN患者神经传导与TNF-α、MIP-1α、IL-1β的变化密切相关。Objective To analyze the changes of inflammatory factors in diabetic peripheral neuropathy(DPN)and their correlation with nerve conduction velocity.Methods A total of 114 patients with type 2 diabetes(T2DM)admitted to the First People′s Hospital of Lianyungang City were selected and divided into T2DM group(n=34)and DPN group(n=80)according to the Michigan Neuropathy Screening Form.The patient′s general information was collected,and glucose related indexes[fasting plasma glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA_(1)c)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-10(IL-10),macrophage inflammatory protein-1(MIP-1)],and nerve conduction velocity(motor and sensory conduction velocity of median nerve and peroneal nerve)were detected.The general information,inflammatory factors and nerve conduction velocity of the two groups of patients were compared.The correlation between inflammatory factors and nerve conduction velocity and the influencing factors of nerve conduction abnormalities were analyzed.Results The course of disease,FPG,2 hPG,HbA_(1)c,TNF-α,and MIP-1αin the DPN group were higher than those in the T2DM group,while the motor and sensory conduction velocity of IL-1β,IL-10,median nerve and peroneal nerve were lower than those in the T2DM group(P<0.05).IL-1βwas positively correlated with motor and sensory conduction velocity of median nerve and peroneal nerve(P<0.05),whereas TNF-αand MIP-1αare negatively correlated with motor and sensory conduction velocity of median nerve and peroneal nerve(P<0.05).Course of disease,HbA_(1)c,and TNF-αwere influencing factors of motor conduction velocity of median nerve(P<0.05),and age,TNF-αand HbA_(1)c were the influencing factors of conduction abnormalities of median nerve and peroneal nerve(P<0.05).Conclusion The nerve conduction of DPN patients is closely related to the changes of TNF-α,MIP-1α,and IL-1β.

关 键 词：糖尿病神经病变 炎症 神经传导 

分 类 号：R587.25[医药卫生—内分泌]