臂-踝脉搏波传导速度与2型糖尿病周围神经病变的相关性研究

Correlation between the brachial-ankle pulse wave velocity and peripheral neuropathy in patients with type 2 diabetes

目的探讨臂-踝脉搏波传导速度(ba PWV)与2型糖尿病周围神经病变(DPN)的相关性。方法选取住院的2型糖尿病患者344例,根据有无DPN将患者分为DPN组(n=196)和无DPN组(n=148),再根据ba PWV四分位数分为Q1、Q2、Q3、Q4组(n=86),进行组间各指标差异比较及DPN相关影响因素的分析。结果与无DPN组相比,DPN组患者ba PWV更高(P<0.01)。以ba PWV四分位数分组,ba PWV由Q1组的1023cm/s上升到Q4组的3279cm/s时,出现中/重度神经病变体征的患者比例由27.9%增加到68.2%(P<0.05)。DPN危险因素的单因素分析显示,SBP≥140mm Hg、ba PWV≥1600m/s、高血压、糖尿病视网膜病变(DR)、糖尿病肾病(DN)与DPN密切相关(P<0.01)。多因素logistic回归校正年龄、SBP及尿白蛋白/肌酐对ba PWV的影响后,糖尿病病程、DR是DPN的独立危险因素(P<0.05)。结论 2型糖尿病患者升高的ba PWV与DPN具有一定的相关性。

Objective To investigate the relationship between brachial-ankle pulse wave velocity（ba PWV） and the peripheral neuropathy in patients with type 2 diabetes（DPN）.Methods A retrospective cross-sectional study was conducted involving 344 patients with type 2 diabetes.All patients were grouped according to the presence or absence of diabetic peripheral neuropathy（DPN）,and they were further divided into four groups according to ba PWV quartiles.The differences and correlations of related indexes between groups were analyzed.Results The ba PWV was higher in patients with DPN than in those without DPN（P〈0.01）.As the ba PWV increased from 1023cm/s to 3279cm/s,the proportion of patients with moderate/severe signs of neuropathy rose from 27.9% to 68.2%（P〈0.05）.Univariate analysis of risk factors for DPN revealed that age≥60 years,duration of diabetes ≥10years,SBP ≥140mm Hg,ba PWV ≥1600cm/s,hypertension,diabetic retinopathy（DR）,and diabetic nephropathy（DN） were closely related to DPN（P〈0.05）.After adjusting the impacts of age,SBP,urine albumin-creatinine ratio on ba PWV,multivariate logistic regression analysis indicated that diabetic duration and DR were independent risk factors for DPN（P〈0.05）.Conclusion Increased ba PWV shows some correlation with DPN in patients with type 2 diabetes.