高尿酸血症与糖尿病周围神经病变的相关性研究

Correlation between hyperuricemia and peripheral neuropathy induced by diabetes

目的:探讨高尿酸血症(HUA)对糖尿病周围神经病变(DPN)的影响。方法:2008年7月～2010年12月收治的84例资料完整的HUA合并DPN患者,按照治疗方法的不同随机分为观察组和对照组,对照组采用降糖治疗+神经病变的基础治疗,观察组采用降糖治疗+神经病变基础治疗+降尿酸治疗,比较两组患者治疗前、后的血尿酸(UA)、神经症状评分(NSS)、神经缺陷评分(NDS)及其他相关因素如糖化血红蛋白(HbA1c)、高敏C反应蛋白(hsCRP)、尿微量白蛋白(uMAL)、血肌酐(sCr)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)、收缩压(SBP)、腰围的变化。结果:两组治疗后HbA1c、hsCRP、uMAL、LDL-c、SBP、腰围均有下降,HDL-c均上升,与治疗前相比差异有统计学意义(P<0.05);观察组的NSS、NDS评分、UA、hsCRP、uMAL改善均显著优于对照组(P<0.05)。结论:m-ALB、炎症反应、血压、脂代谢紊乱可能为HUA合并DPN的危险因素,采用降尿酸、降糖及神经病变的治疗对HUA合并DPN有重要意义。

Objective： To explore the correlation betwen hyperuricemia（HUA） and peripheral neuropathy induced by diabetes（DPN）.Methods： Data of 84 patients with HUA complicated with DPN that were admitted into our hospital during July,2008 and December,2010 were retrospectively analyzed.According to the different treatments,they were divided into trial group and control group,which was treated by hypoglycemic therapy ＋ neuropathy foundation treatment and hypoglycemic therapy ＋ neuropathy foundation treatment ＋ drop uric acid treatment,respectively.Blood creatinine（sCr）,blood uric acid（UA）,neuropathy symptoms（NSS）,neuropathy signs（NDS）,glycated hemoglobin（HbA1c）,high sensitive c-reactive protein（hsCRP）,microal buminuria（uMAL）,low density lipoprotein cholesterol（LDL）-C）,high-density lipoprotein cholesterol（hdl-c）,systolic blood pressure（SBP） and changes in waist size before and after the treatment were compared between the two groups.Results： After treatment,hsCRP HbA1c,uMAL,LDL-c,SBP,waist size decreased,while hdl-c increased in both groups,which were all significantly different from that before the treatment（P 0.05）.But the observation group hsCRP,uMAL improve significantly better than the control group,P 0.05;And the observation group of NDS NSS,ratings,UA improve significantly better than the control group,P 0.05.Conclusion uMAl,inflammation,blood pressure,lipid metabolism disorders may launch the merger for DPN risk factors,adopt drop uric acid,hypoglycemic and neuropathy treatment on the merger has important significance DPN launch.The trial group showed better improvements of NSS and NDS scores,and UA、hsCRP、uMAL levels than the control group.Conclusions： m-ALB,inflammation,blood pressure,Lipid metabolism disorder might be risk factors for the occurrence of HUA complicated DPN,treatments to improve hyperuricemia and peripheral neuropathy is effective on the disease.