神经元特异性烯醇化酶与2型糖尿病周围神经病变的相关性研究

Association study of neuron-specific enolase and type 2 diabetic peripheral neuropathy

目的探讨2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平的变化及临床意义。方法根据是否存在DPN将176例2型糖尿病(type 2 diabetes mellitus,T2DM)患者分为单纯T2DM(SDM)组66例和DPN组110例。采用电化学发光法测定两组研究对象的血清NSE水平,并分析DPN发生的危险因素。结果 DPN组血清NSE浓度是(11.32±2.60)ng/ml,高于SDM组的(10.26±2.41)ng/ml(t=2.667,P<0.01);DPN组病程、年龄、空腹血糖、糖化血红蛋白、血肌酐、D-二聚体及尿微量白蛋白/肌酐较SDM组高,DPN组体重指数和空腹C肽较SDM组水平低;多元逐步回归分析NSE水平升高的影响因素,最终年龄、病程、收缩压、HbA1c进入方程;Logistic回归分析显示NSE、年龄、病程、血肌酐及糖尿病肾脏病是DPN发生的独立危险因素(P<0.05)。结论 NSE可能是DPN潜在的生物学标志物。

Objective To examine the level and clinical significance of serum neuron-specific enolase（ NSE） in type 2 diabetic peripheral neuropathy（ DPN） patients. Method 176 patients with type 2 diabetes were divided into simple type 2 diabetes mellitus（SDM）group（n=66）and DPN group（n=110）according to the existing of DPN. All patients are inpatients from the third hospital of hebei medical university since 2015 May to 2015 December. The level of ser-um NSE was determined by chemiluminescence method. Logistic regession analysis was used to analyzed the risk fac-tors of DPN. Result The serum NSE in DPN group was（11. 32±2. 60）ng/ml,higher than（0. 26±2. 41）ng/ml in SDM group （ t=2. 667, P〈0. 01 ）;DPN had a higher duration, age, fasting blood glucose, glycated hemoglobin （HbA1c）,serum creatinine, D-dimer and urinary albumin/creatinine ratio than those of SDM patients,DPN group had a lower body mass index（ BMI） and fasting C-peptide than that of SDM patients;Stepwise multiple regression a-nalysis for factors those elevated NSE level,eventually age,duration,systolic blood pressure,HbA1c were into the e-quation;Logistic regression analysis showed that NSE, age, duration, serum creatinine and diabetic kidney disease were independent risk factors for DPN（P〈0. 05）. Conclusion NSE might be a potential biological marker of DPN.