2型糖尿病外周感觉神经病变和心自主神经病变关系的研究

Relationship between peripheral neuropathy and cardiovascular autonomic neuropathy in type 2 diabetes

目的探讨T2DM外周感觉神经病变和心自主神经病变之间的关系。方法选取T2DM患者148例,采集临床资料,测定FPG、HbA1c及LDL-C等生化指标;进行定量感觉神经检查(以色列TSA-II定量感觉神经测定仪),结合临床症状评价糖尿病外周感觉神经病变;进行心血管反射试验检查,结合临床症状评价糖尿病心自主神经病变。结果外周感觉神经病变的患病率为28%,心自主神经病变的患病率为10%;无外周感觉神经病变的患者中心自主神经病变的患病率为6%,存在外周感觉神经病变的患者中心自主神经病变的患病率为21%;与对照组相比,外周感觉神经病变组和心自主神经病变组的病程较长,FPG、HbA1c及LDL-C水平较高,差异有统计学意义(P<0.05)。结论糖尿病心自主神经病变可发生于无外周感觉神经病变的患者;病程、FPG、HbA1c及LDL-C可能为糖尿病外周感觉神经病变和心自主神经病变的危险因素。

Objective To investigate the relationship between diabetic cardiovascular autonomic neuropathy and peripheral neuropathy in type 2 diabetes.Methods The clinical data of 148 T2DM patients was collected and the biochemical indices,including FPG,HbA1c,and LDL-C of these patients,were determined.The diabetic peripheral neuropathy was diagnosed according to the quantitative sensory test（Neurosensory Analyzer Model TSA-II） and clinical symptoms.The diabetic cardiovascular autonomic neuropathy was estimated with cardiovascular reflex test and clinical symptoms.Results The prevalence of diabetic peripheral neuropathy was 28% and that of the cardiovascular autonomic neuropathy was 10%.In the patients without diabetic peripheral neuropathy,the prevalence of cardiovascular autonomic neuropathy was 6%,while in those with diabetic peripheral neuropathy,the prevalence of cardiovascular autonomic neuropathy was 21%.Compared with the control group,the disease duration in the diabetic peripheral neuropathy and cardiovascular autonomic neuropathy groups was longer,and the levels of FPG,HbA1c,and LDL-C were higher（P0.05）.Conclusion Diabetic cardiovascular autonomic neuropathy can occur in the patients without peripheral neuropathy.The disease duration,FPG,HbA1c,and LDL-C may be the risk factors for diabetic cardiovascular autonomic neuropathy and peripheral neuropathy.