2型糖尿病周围神经病变的危险因素及相关炎性反应因子分析

Risk factors and related inflammatory factors analysis of diabetic peripheral neuropathy in patients with ty

目的分析2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的患病情况,并研究其相关危险因素及炎性因子。方法选择2015-01至2016-07临床确诊为2型糖尿病的住院患者,根据DPN诊断标准分为糖尿病周围神经病变组(n=224)及糖尿病非周围神经病变组(n=116),分别检查两组是否合并糖尿病视网膜病变(diabetic retinopathy,DR)、是否合并糖尿病外周血管病变(diabetic peripheral vascular,DPV),并分析年龄、体重、身体质量指数(BMI)、病程、生化指标炎性反应因子与DPN的相关性。对每个指标进行单因素分析,然后进行非条件多因素Logistic分析。结果 (1)糖尿病周围神经病变组(n=224),糖尿病非周围神经病变组(n=116),糖尿病周围神经病变患病率为65.9%;(2)糖尿病周围神经病变组中合并外周血管病变的患者比例(69%)明显高于糖尿病非周围神经病变组(50%),经χ2检验,差异有统计学意义(χ2=5.723,P<0.05);(3)在所分析的各项因素中,糖尿病周围神经病变组的病程、Hb A1c、LDL-C、IL-6、TNF-α、SIL-2R与糖尿病非周围神经病变组的比较,差异有统计学意义(tw 2.084~3.407,P<0.05),其余因素比较差异无统计学意义。(4)Logistic多因素分析:病程、Hb A1c、LDL-C、TNF-α、SIL-2R,以及是否合并外周血管病变均是DPN的独立危险因素(OR:0.455~1.655,P<0.05)。结论随着病程的延长,外周血管的病变,血糖、血脂的升高,以及相关炎性因子的异常,都会使糖尿病神经病变的病情加重。

Objective Analyze the prevalence situation of Diabetic Peripheral Neuropathy in type 2 diabetes mellitus, study the related risk factors and inflammatory factors. Methods From January 2015 to July 2016 ,according to DPN diagnostic criteria ,the patients were diagnosed as type 2 diabeteswere divided into diabetic peripheral neuropathy group and non group. Respectively, check whether combined with diabetic retinopathy and peripheral vascular disease, then analysis of age, weight, BMI, course of disease, biochemical indicator, meanwhile, analyse single factor of each index, and then Logistic multivariate analysis. Results （ 1 ） The prevalence of diabetic peripheral neuropathy in the study population was 65.9% ; （2）The number of combined with peripheral vascular disease in the diabetic peripheral neuropathy group（69% ） was significantly higher than that in non diabetic peripheral neuropathy group （ 50% ）, through the X2 test, the difference was statistically significant （X2 = 5. 723, P 〈 0.05 ） ; （ 3 ） compared with non group, in the a- nalysis of various factors, the HbAl e ,LDL-C ,IL-6 、TNF-α ,SIL-2R and disease course of diabetic peripheral neuropathy group was statistically significant （ t = 2. 084 - 3. 407, P 〈 0.05 ）. But there was no statistically significant difference compared to other factors. （4） Logistic multivariate analysis：Course, HbA1 c, LDL-C ,TNF-α,SIR-2R and combined with peripheral vascular disease are independent risk factors for DPN （ OR = 0. 455 - 1. 655,P 〈 0.05 ）. Conclusions The extension of the disease course, peripheral vascular disease, and blood glucose, blood lipid levels and related inflammatory factors of abnormal, will make diabetic neuropathy exacerbations.