糖尿病性心自主神经、末梢神经病变与糖尿病微血管并发症的关系

Clinical status of diabetic cardiovascular autonomic neuropathy and peripheral polyneuropathy in patients with diabetes mellitus

目的 观察糖尿病性心自主神经病变和末梢神经病变的患病率及其与其他糖尿病慢性并发症的关系。 方法 利用心自主神经功能检测系统和神经电生理检测仪测定 30 8例糖尿病患者(平均年龄 49岁 ,平均 Hb A1 c9.8% ,平均病程 14年 )的心自主神经功能和肢体的末梢神经传导速度、皮肤痛温觉、振动觉 ,同时检测 2 4h尿白蛋白排泄率和眼底视网膜照相。 结果 糖尿病患者心自主神经病变患病率为 47.1% ,末梢神经病变患病率为 5 4.2 % ,两者呈显著正相关 ,并与病程和糖尿病控制状况呈显著正相关 ,并发糖尿病性神经病变患者并发其他糖尿病慢性并发症的机率增高。 结论 糖尿病性神经病变患病率较高 ,并与糖尿病其他慢性并发症密切相关。

Objective To examine the prevalence of diabetic neuropathy and its relationship with other chronic diabetic complications in patients with diabetes mellitus. Methods 308 patients with diabetes mellitus (162 men, 146 women; mean age of 49 years, mean diabetes duration of 14 years, mean HbA1c of 9.8%) were observed. Tests assessing cardiovascular autonomic functions and peripheral nerve functions and retinograph were performed in each patient. Urine albumin excretion was determined. Results The prevalence was 47.1% for diabetic cardiovascular autonomic neuropathy and 54.2% for diabetic peripheral neuropathy. There was significant correlation between diabetic cardiovascular autonomic neuropathy and peripheral neuropathy ( P <0.01). The diabetic neuropathy was associated significantly with duration of diabetes and quality of glycaemic control ( P <0.05,0.01). There were significant high prevalence of diabetic retinopathy and nephropathy in patients with diabetic neuropathy compared with that without diabetic neuropathy ( P <0.01). Conclusion There is high prevalence of diabetic neuropathy in patients with diabetes mellitus. Diabetic neuropathy is related to other diabetic chronic complications.