贝前列素钠改善糖尿病周围神经病变患者平衡功能的疗效观察  

Efficacy of beraprost sodium in improving balance function in patients with diabetic peripheral neuropathy

作　　者：屈丽媛 何美男 范新钊 刘乐融 李景香[3] 刘小龙[4] 何飞英[3] 孙丹[3] 高方[3] 邹梦晨[3] 薛耀明[3] 曹瑛[3] Qu Liyuan;He Meinan;Fan Xinzhao;Liu Lerong;Li Jingxiang;Liu Xiaolong;He Feiying;Sun Dan;Gao Fang;Zou Mengchen;Xue Yaoming;Cao Ying(First Clinical Medical College of Southern Medical University,Guangzhou 510515,China;Department of Endocrinology and Metabolisrn,Nanfang Hospital Zengcheng Branch,Guangzhou 511338,China;Department of Endocrinology and Metabolism,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Otorhinolaryngology,Head and Neck Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学第一临床医学院,广州510515 [2]南方医院增城分院内分泌与代谢科,广州511338 [3]南方医科大学南方医院内分泌与代谢科,广州510515 [4]南方医科大学南方医院耳鼻咽喉头颈外科,广州510515

出　　处：《中华糖尿病杂志》2023年第10期917-924,共8页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：广东省医学科学技术研究基金(C2022067);南方医科大学南方医院院长基金(2022A024)。

摘　　要：目的探讨贝前列素钠改善糖尿病周围神经病变(DPN)患者平衡功能的疗效。方法选取2021年7月至2022年9月在南方医科大学南方医院内分泌代谢科就诊的DPN患者,采用随机数字表法分配进入研究组(15例)和对照组(14例),治疗12周。研究组方案为口服贝前列素钠40 μg(3次/d)+甲钴胺片500 μg(3次/d);对照组仅口服甲钴胺片500 μg(3次/d)。收集患者的一般资料,进行神经传导速度测定并采用多伦多临床神经病变评分(TCSS)进行严重程度分级;进行平衡功能评估,记录Berg平衡量表评分(BBS)、足底压力中心晃动的轨迹总长度(LNG)、轨迹包络图形的面积(SSKG)和单位时间轨迹长(LNG/T);进行前庭功能评估,记录颈性前庭诱发肌源性电位(VEMP)和眼性VEMP检查的P1和N1波潜伏期、振幅和双侧不对称度。观察干预前后上述各项指标的变化,并采用t检验、配对t检验、非参数秩和检验或配对秩和检验进行比较。结果研究组和对照组的基线资料基本均衡。研究组干预后BBS为55.00(54.00,56.00)分,高于对照组干预后的54.00(53.00,55.00)分,差异有统计学意义(P=0.011)。在强化闭目Romberg试验中,研究组干预前LNG为(1 825.30±735.57)mm,干预后为(1 329.54±582.34)mm,较干预前下降,差异有统计学意义(P=0.035)。研究组干预前LNG/T为(74.26±20.65)mm/s,干预后为(63.99±15.75)mm/s,较干预前下降,差异有统计学意义(P=0.005)。对照组干预前后LNG及LNG/T的差异均无统计学意义(P>0.05)。在颈性VEMP中,研究组干预前后的P1潜伏期、N1潜伏期差异均有统计学意义,干预后较干预前下降(P<0.05);在眼性VEMP中,干预后研究组振幅(3.90±1.58)μV高于对照组(2.16±0.46)μV,差异有统计学意义(P=0.007)。研究组干预前TCSS为(8.73±2.05)分,干预后为(7.07±2.34)分,较干预前下降,差异有统计学意义(P=0.002);对照组干预前后的差异无统计学意义(P=0.177)。研究组干预后正中神经、尺神经、胫�Objective To investigate the efficacy of beraprost sodium in improving balance function in patients with diabetic peripheral neuropathy(DPN).Methods DPN patients attending the Department of Endocrinology and Metabolism,Nanfang Hospital,Southern Medical University from July 2021 to September 2022 were selected and allocated to the study group(15 cases)and the control group(14 cases)for 12 weeks of treatment using the random number table method.The study group received 40μg oral beraprost sodium(3 times per day)+500μg methylcobalamin tablets(3 times per day),and the control group received only 500μg oral methylcobalamin tablets(3 times per day).General information of the patients was collected,nerve conduction velocity was measured and severity was graded using the Toronto Clinical Neuropathy Score(TCSS);balance function was assessed by recording the Berg Balance Scale score(BBS),the total length of the trajectory of the plantar center of pressure sway(LNG),the area of the trajectory envelope graphic(SSKG),and the length of the trajectory per unit of time(LNG/T);and vestibular function was assessed by recording the P1 and N1 waves latency,amplitude,and asymmetry ratio of the cervical VEMP and ocular VEMP examination.The changes in the above indices before and after the intervention were observed and compared using a t test,paired t test,non-parametric rank sum test,or paired rank sum test.Results The baseline data of the study and control groups were balanced.The BBS of the study group was 55.00(54.00,56.00)points after the intervention,which was higher than the 54.00(53.00,55.00)points after the intervention in the control group,and the difference was statistically significant(P=0.011).In the intensive closed-eye Romberg test,the LNG of the study group before the intervention was(1825.30±735.57)mm,and after the intervention was(1329.55±582.34)mm,which was a decrease from the pre-intervention period,and the difference was statistically significant(P=0.035).LNG/T in the study group was(74.26±20.65)mm/s before

关 键 词：糖尿病周围神经病变 贝前列素钠 前庭功能 平衡功能 

分 类 号：R587.2[医药卫生—内分泌] R747.9[医药卫生—内科学]