糖尿病周围神经病变及其累及区域对2型糖尿病患者发生动脉粥样硬化性心血管疾病的影响  

Effect of Diabetic Peripheral Neuropathy and Its Involved Areas on Atherosclerotic Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus

作　　者：尤帅 王莉梅 马有忠 李娜 尹鸿涛[1,2] 王丽婷 甄东户[2] YOU Shuai;WANG Limei;MA Youzhong;LI Na;YIN Hongtao;WANG Liting;ZHEN Donghu(The First School of Clinical Medicine of Lanzhou University,Lanzhou 730000,China;Department of Endocrinology,the First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃省兰州市730000 [2]兰州大学第一医院内分泌科,甘肃省兰州市730000

出　　处：《实用心脑肺血管病杂志》2025年第3期45-50,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：甘肃省自然科学基金资助项目(23JRRA1594);甘肃省科技计划项目(23YFFA0032)。

摘　　要：目的探讨糖尿病周围神经病变(DPN)及其累及区域对2型糖尿病患者发生动脉粥样硬化性心血管疾病(ASCVD)的影响。方法回顾性选取2017年1月—2021年10月国家标准化代谢性疾病管理中心(MMC)数据库中就诊于兰州大学第一医院内分泌科的2型糖尿病患者1707例。收集患者的临床资料、DPN发生情况及其累及区域。根据ASCVD发生情况将患者分为ASCVD组(138例)和非ASCVD组(1569例)。采用多因素Logistic回归分析探讨2型糖尿病患者发生ASCVD的影响因素。结果ASCVD组患者年龄大于非ASCVD组,有高血压史者占比、有高脂血症史者占比、有高尿酸血症史者占比、C肽(120 h)、血肌酐、蛋白尿发生率、DPN发生率高于非ASCVD组,糖尿病病程长于非ASCVD组,糖化血红蛋白(HbA1c)、白蛋白低于非ASCVD组(P<0.05);ASCVD组与非ASCVD组DPN累及区域比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄[OR=1.042,95%CI(1.016~1.069)]、高血压史[OR=1.627,95%CI(1.082~2.438)]、高脂血症史[OR=1.839,95%CI(1.231~2.748)]、高尿酸血症史[OR=2.369,95%CI(1.409~3.985)]、糖尿病病程[OR=1.003,95%CI(1.000~1.005)]、C肽(120 h)[OR=1.181,95%CI(1.040~1.342)]、DPN[OR=2.054,95%CI(1.222~3.452)]、DPN累及区域[2与0比较:OR=1.849,95%CI(1.010~3.384);3与0比较:OR=2.649,95%CI(1.409~4.906);4与0比较:OR=4.568,95%CI(2.222~9.393)]是2型糖尿病患者发生ASCVD的独立影响因素(P<0.05)。结论DPN及其累及区域是2型糖尿病患者发生ASCVD的独立影响因素。Objective To explore the effect of diabetic peripheral neuropathy(DPN)and its involved areas on atherosclerotic cardiovascular disease(ASCVD)in patients with type 2 diabetes mellitus.Methods A total of 1707 patients with type 2 diabetes mellitus who visited the Department of Endocrinology of the First Hospital of Lanzhou University in the National Standardized Metabolic Disease Management Center(MMC)database from January 2017 to October 2021 were retrospectively selected.General information,DPN occurrence situation,and its involved areas of patients were collected.The patients were divided into the ASCVD group(n=138)and the non-ASCVD group(n=1569)according to the occurrence of ASCVD.Multivariate Logistic regression analysis was used to explore the influencing factors of ASCVD in patients with type 2 diabetes mellitus.Results The age in ASCVD group was older than that in non-ASCVD group,the proportion of patients with hypertension,the proportion of patients with hyperlipidemia,the proportion of patients with hyperuricemia,C-peptide(120 h),serum creatinine,proteinuria incidence,and DPN incidence were higher than those in non-ASCVD group,duration of diabetes was longer than that in non-ASCVD group,glycosylated hemoglobin(HbA1c),albumin were lower than those in non-ASCVD group(P<0.05).Multivariate Logistic regression analysis showed that age[OR=1.042,95%CI(1.016-1.069)],hypertension history[OR=1.627,95%CI(1.082-2.438)],hyperlipidemia history[OR=1.839,95%CI(1.231-2.748)],hyperuricemia history[OR=2.369,95%CI(1.409-3.985)],duration of diabetes[OR=1.003,95%CI(1.000-1.005)],C-peptide(120 h)[OR=1.181,95%CI(1.040-1.342)],DPN[OR=2.054,95%CI(1.222-3.452)],DPN involved areas[2 vs 0:OR=1.849,95%CI(1.010-3.384);3 vs 0:OR=2.649,95%CI(1.409-4.906);4 vs 0:OR=4.568,95%CI(2.222-9.393)]were independent influencing factors of ASCVD in patients with type 2 diabetes mellitus(P<0.05).Conclusion DPN and its involved areas are independent influencing factors of ASCVD in patients with type 2 diabetes mellitus.

关 键 词：糖尿病 2型 冠状动脉疾病 周围神经系统疾病 影响因素分析 

分 类 号：R587.1[医药卫生—内分泌]