2型糖尿病周围神经病变患者嗅觉、味觉功能评估及意义的研究

Evaluation and significance of olfactory and taste function in patients with type 2 diabetic peripheral neuropathy

目的探讨T2DM周围神经病变患者嗅觉、味觉功能情况及临床意义。方法选取2015年9月至2017年12月于我院内分泌科住院及门诊接受治疗的90例T2DM患者(T2DM组)、63例糖尿病周围神经病变患者(DPN组)以及体检中心健康体检人群104名(NC组),分析各组嗅觉、味觉功能指标的表达差异。结果 DPN组病程、长期吸烟史、HbA1c、高敏C反应蛋白(hsC-RP)、间接胆红素(IBIL)与T2DM组、NC组比较,差异有统计学意义(P<0.05或P<0.01)。Pearson相关分析显示,嗅觉评分总分(TDI)、味觉评分总分(DTV)均与病程、长期吸烟史、HbA1c、LDL-C、hsC-RP呈负相关(P<0.05或P<0.01),与IBIL呈正相关(P<0.05)。Logistic回归分析结果显示,病程(OR=2.232,95%CI1.443～6.223)、长期吸烟史(OR=1.826,95%CI 1.076～5.444)、HbA1c(OR=2.117,95%CI 1.572～8.336)、LDL-C(OR=1.909,95%CI 1.201～6.224)、IBIL(OR=1.776,95%CI 1.063～5.023)及hsC-RP(OR=2.446,95%CI1.338～7.061)是DPN的危险因素。结论 T2DM并发DPN患者存在嗅觉、味觉功能障碍,可能与血糖控制、炎症反应等有关。

Objective To investigate the olfactory and taste function in patients with diabetic peripheral neuropathy and its clinical significance. Methods 90patients with type 2diabetes (T2DM group), 63patients with diabetic peripheral neuropathy (DPN group)and 104healthy volunteers (NC group)were selected.The indexes of olfactory and taste function were compared among different groups. Results There were significant difference in duration,long-term smoking history,glycated hemoglobin (HbA 1 c), high-sensitivity C-reactive protein (hsC-RP)and indirect bilirubin (IBIL)in DPN group than that in T2DM group and NC group (P<0.05orP<0.01).Correlation analysis showed that the total score hazard discrimination (TDI)and the determination of taste value (DTV)were negatively correlated with the course of disease,long-term smoking history,HbA 1 c,LDL-C and hsC-RP ; but positively correlated with IBIL (P<0.05orP<0.01).Logistic regression analysis showed that the course of disease (OR =2.232,95% CI 1.443~6.223), long-term smoking history (OR =1.826,95% CI 1.076~ 5.444), HbA 1 c (OR =2.117,95% CI 1.572~8.336), LDL-C (OR =1.909,95% CI 1.201~6.224), IBIL (OR =1.776,95% CI 1.063~5.023)and hsC-RP (OR =2.446,95% CI 1.338~7.061)were risk factors for DPN. Conclusion There are obvious olfactory and taste dysfunction in T2DM patients with DPN,which may be related to blood sugar control and inflammatory reaction.