依帕司他对老年糖尿病周围神经病变患者同型半胱氨酸的影响

Effects of epalrestat on homocysteine of elderly patients with diabetic peripheral neuropathy

目的探讨依帕司他治疗老年糖尿病周围神经病变（DNP）的疗效及对同型半胱氨酸（Hcy）的影响。方法选取我院2012年1月~2014年1月收治入院的200例糖尿病周围神经病变患者随机分为两组,对照组患者给予甲钴胺注射液0.5mg,静脉推注1次/d。观察组在对照组基础上,予依帕司他片50mg,3次/d,口服,疗程12周;治疗前后均进行肌电图检测四肢运动神经（SNCV）、感觉神经（MNCV）传导速度,并检测治疗前后Hcy变化。结果观察组显效60例（60.0%）,有效30例（30.0%）,无效10例（10.0%）;对照组显效28例（28.0%）,有效45例（45.0%）,无效27例（27.0%）;两组总有效率为90.0%和73.0%,差异有统计学意义（x2=4.021,P〈0.05）。所有患者治疗期间均无明显不良反应;两组患者治疗后MNCV和SNCV明显均较治疗前提高,差异有统计学意义（P〈0.05）;观察组患者治疗后MNCV和SNCV提高较对照组治疗后明显,差异有统计学意义（P〈0.05）;观察组患者治疗后Hcy下降较治疗前及对照组治疗后明显,差异有统计学意义（P〈0.05）。结论依帕司他片治疗老年糖尿病周围神经病变的效果显著,并能明显降低血液中Hcy的水平。

Objective To investigate curative effect of epalrestat in treatment of elderly patients with diabetic peripheral neuropathy（DNP）and its effect on homocysteine（Hcy）. Methods 200 patients with diabetic peripheral neuropathy who were admitted to our hospital from January 2012 to January 2014 were selected and randomly allocated to the control group and the observation group.Patients in the control group were given 0.5mg of mecobalamin injection with intravenous injection once a day.Patients in the observation group were given 50 mg of epalrestat tablets with three times a day by mouth and the course of treatment was 12 weeks.Sural nerve conduction velocity（SNVC）and motor nerve conduction velocity were detected by electromyography before and after treatment and Hcy changes before and after treatment were detected. Results In the observation group,60 cases were significantly effective（60.0%）,30 cases were effective（30.0%）and 10 cases were ineffective（10.0%）.In the control group,28 cases were significantly effective（28.0%）,45 cases were effective（45.0%）and 27 cases were ineffective（27.0%）.Total effectively rate of two groups were 90.0% and 73.0% respectively and the differences were statistically significant（x2=402.1,P〈0.05）.No patients had obvious adverse reaction during treatment.MNCV and SNCV after treatment of patients in two groups were significantly improved compared with those before treatment and difference had statistical significance（P0.05）.MNCV and SNCV after treatment of the observation group were more significantly increased than those of the control group and difference had statistical significance（P〈0.05）.Decrease of Hcy after treatment of the observation group was more significant than that before treatment and that after treatment of the control group.Difference has statistical significance（P〈0.05）. Conclusion Epalrestat tablet in the treatment of elderly patients with diabetic peripheral neuropathy has a more significant effect and it can significantly reduce the homocysteine level in the blood.