血清肿瘤坏死因子-α、糖化血红蛋白水平与痛性糖尿病神经病变的关系研究  

Relationships of serum tumor necrosis factor-αand glycated hemoglobin levels with painful diabetic neuropathy

作　　者：刘小位 潘娟 李晶 李慧 LIU Xiaowei;PAN Juan;LI Jing;LI Hui(Department of Endocrinology,Xianyang Central Hospital of Shaanxi Province,Xianyang,Shaanxi,712000;Department of Endocrinology,Xi′an Traditional Chinese Medicine Hospital of Shaanxi Province,Xi′an,Shaanxi,710021)

机构地区：[1]陕西省咸阳市中心医院内分泌科,陕西咸阳712000 [2]陕西省西安市中医院内分泌科,陕西西安710021

出　　处：《实用临床医药杂志》2025年第4期50-54,共5页Journal of Clinical Medicine in Practice

基　　金：陕西省重点研发计划项目(2022SF-427)。

摘　　要：目的探讨血清肿瘤坏死因子-α(TNF-α)、糖化血红蛋白(HbA1c)水平与2型糖尿病(T2DM)患者发生痛性糖尿病神经病变(PDN)的关系。方法选取225例T2DM患者作为研究对象,根据是否发生PDN分为PDN组52例和非PDN组173例,收集并比较2组患者的临床资料。采用多因素Logistic回归模型分析患者发生PDN的危险因素,并绘制受试者工作特征(ROC)曲线评估TNF-α、HbA1c对T2DM患者发生PDN的预测价值。结果PDN组患者的T2DM病程长于非PDN组,空腹血糖(FBG)、HbA1c、C反应蛋白(CRP)和TNF-α水平高于非PDN组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,T2DM病程长、TNF-α水平高、HbA1c水平高是T2DM患者发生PDN的独立危险因素(P<0.05,OR>1);ROC曲线分析结果显示,TNF-α与HbA1c联合预测T2DM患者发生PDN的曲线下面积为0.877(95%CI:0.826~0.916),大于TNF-α、HbA1c单独预测的曲线下面积[0.684(95%CI:0.619~0.745)、0.764(95%CI:0.703~0.818)]。结论血清TNF-α、HbA1c水平高是T2DM患者发生PDN的独立危险因素,两者联合检测对T2DM患者的PDN发生风险具有较高的预测效能。Objective To investigate the relationships of tumor necrosis factor-α(TNF-α)and glycated hemoglobin(HbA1c)with the occurrence of painful diabetic neuropathy(PDN)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 225 patients with T2DM were enrolled and divided into PDN group(52 patients)and non-PDN group(173 patients)based on the presence of PDN.Clinical data of the two groups were collected and compared.A multivariate Logistic regression model was used to analyze risk factors for PDN,and a receiver operating characteristic(ROC)curve was plotted to assess the predictive value of TNF-αand HbA1c for PDN in T2DM patients.Results Patients in the PDN group had a longer duration of T2DM,higher levels of fasting blood glucose(FBG),HbA1c,C-reactive protein(CRP),and TNF-αcompared with the non-PDN group(P<0.05).Multivariate Logistic regression analysis showed that a longer duration of T2DM,higher TNF-αlevels,and higher HbA1c levels were independent risk factors for PDN in T2DM patients(P<0.05,OR>1).ROC curve analysis revealed that the area under the curve for the combined prediction of PDN in T2DM patients by TNF-αand HbA1c was 0.877(95%CI,0.826 to 0.916),which was greater than that of TNF-αand HbA1c alone[0.684(95%CI,0.619 to 0.745)and 0.764(95%CI,0.703 to 0.818),respectively].Conclusion High serum levels of TNF-αand HbA1c are independent risk factors for PDN in T2DM patients,and the combined detection of two biomarkers has high predictive efficacy for the risk of PDN in T2DM patients.

关 键 词：痛性糖尿病神经病变 肿瘤坏死因子-Α 糖化血红蛋白 C反应蛋白 病程 

分 类 号：R587.2[医药卫生—内分泌] R446[医药卫生—内科学] R319[医药卫生—临床医学]