腺苷钴胺治疗对老年糖尿病周围神经病变患者血清同型半胱氨酸水平的影响

The impact of cobamamide on the serum homocysteine in the aged patients with diabetic peripheral neuropathy

目的探讨血清总同型半胱氨酸(Hcy)水平与老年T2DM周围神经病变(DPN)的关系。方法对我院2008年8月至2009年8月住院的78例老年T2DM患者及20例非糖尿病患者进行血清总同型半胱氨酸(Hcy)水平测定,给予DPN患者腺苷钴铵1mg肌内注射,14d为1疗程,连续治疗2个疗程,比较高Hcy血症DPN患者治疗前后的血清Hcy水平及神经电生理变化。结果 DPN组患者(46例)血清Hcy水平明显高于无DPN组(32例)和非糖尿病对照组(P<0.05);高Hcy血症DPN患者(27例)神经传导速度低于血清总Hcy正常的DPN患者(P<0.01)。高Hcy血症DPN患者经腺苷钴铵治疗后,血清Hcy水平明显下降,神经病变症状和神经传导速度也明显改善,治疗前后差异有统计学意义(P<0.05)。结论老年T2DM周围神经病变患者存在高Hcy血症,降低血清Hcy水平或有助于改善神经病变。

Objective To investigate the relationship between the serum homocysteine （Hcy） and type 2 diabetic peripheral neuropathy （DPN） in the elderly. Methods The level of homocysteine in serum was measured in 78 patients with type 2 diabetes mellitus and 20 normal control subjects in the elderly. The variations of Hcy level were compared among diabetic patients with or without DNP and normal control subjects. Patients with DNP were treated by cobamamide. Results The level of serum Hcy was significantly higher in the DPN patients than in patients without DPN and the control group （P〈0. 05）. The serum Hcy level and motor or sensory nerve conduction velocity of the DPN patients who received cobamamide treatment were obviously improved （all P 〈 0.05）. Conclusions Hyperhomocysteinemia is an independent risk factor for diabetic neuropathy in humans. Efficiently decreasing the levels of hyper-homocysteinemia could improve the electrobiological activity.