血浆纤维蛋白原水平与2型糖尿病神经病变的关系

The relationship between plasma fibrinogen and type 2 diabetic neuropathy

目的探讨纤维蛋白原(FIB)与2型糖尿病神经病变之间的关系。方法选取2型糖尿病患者252例,其中痴呆60例,周围神经病变106例,颅神经病变42例,单纯糖尿病无并发症者44例,另取体检者(健康人群)50例,测定FIB水平。寻找影响FIB因素,予以干预,观察糖尿病神经病变改善情况。结果糖尿病神经病变(痴呆、外周神经病变、颅神经病变)、单纯糖尿病、健康人群三者间FIB差异有统计学意义(F=77.64、114.02、30.84,P值均<0.01);重度糖尿病外周神经病变血浆FIB高于轻度患者(t=5.244 8,P<0.01),而痴呆以及颅神经病变的重度与轻度之间血浆FIB无明显差异(t=0.827 3、0.581 2,P>0.05);高FIB与正常FIB患者相比,吸烟程度、血小板参数(MPV、PDW)等情况有显著的差异性(t=12.375 8、8.671 8、13.191 5,P均<0.01),而血脂水平(TG、TCH、LDL、HDL)、血糖水平(HbA1c)水平则无明显差异(t=1.052 8、1.024 3、0.819 4、0.740 4、1.511 8,P均>0.05);Spearman分析显示,FIB与糖尿病外周神经病变呈正相关(r=0.8743,P<0.01),而与糖尿病脑老化痴呆和颅神经病变之间无显著相关性(r=0.481 8、0.439 4,P值均>0.10)。结论 FIB水平增高是2型糖尿病神经病变的原因之一,戒烟、抗凝治疗有可能延缓病情的进展。

Objective To study the relationship between plasma fibrinogenand type 2diabetic neuropathy.Methods 252 patients with type 2diabetes mellitus（60patients with dementia,106 patients with peripheral neuropathy,42 patients with cranial nerve lesion,44 patients without complications）and 50 cases of healthy people were selected.All subjects were detectedplasma fibrinogen（FIB）.To find the factors which affect FIB and intervene the factors,the improvement of diabetic neuropathy were observed.Results The levels of plasma FIB had significant difference among the patients with diabetic neuropathy,diabetes patients without complications and healthy people（F =77.64,114.02,30.84,P〈0.01）;The FIB of severe diabetic peripheral neuropathy patients was higher than that of mild cases（t=5.2448,P〈0.01）.There were no significant difference of FIB of severe cases and mild cases in dementia patients and cranial nerve lesions patients（t=0.827 3,0.581 2,P 〉0.05）;Compared with normal FIB patients,the number of smoking and the levels of MPV,PDW indiabetic neuropathypatients in high FIB were significantly higher（t=12.3758,8.671 8,13.191 5,P〈0.01）.There were no significant difference in TG,TCH,LDL,HDL and HbA1 cbetween the two groups（t=1.052 8,1.024 3,0.819 4,0.740 4,1.511 8,P〉0.05）.Spearman analysis showed that the levels of FIB was positively correlated with the degrees of diabetic peripheral neuropathy（r=0.8743,P〈0.01）.There were no significant correlation between the levels of FIBand the degree of dementia and cranial neuropathy（r=0.4818、0.4394,P〉0.10）.Conclusion The high level of FIB could be one of factors to worsen the type 2diabetic neuropathy.Giving up smoking and anti-platelet aggregate may delay the disease progression.