糖化血红蛋白与糖尿病患者不同感觉神经亚群受损的相关性研究

Correlation between glycated hemoglobin and damage of different sensory nerve subsets in diabetes patients

目的探讨糖化血红蛋白与2型糖尿病患者三种不同感觉神经亚群病变的相关性。方法选取住院的2型糖尿病患者200例,依据糖化血红蛋白(HbA_1c)数值将所有研究对象分为三组:A组(HbA_1c≤7.5%)、B组(7.5%<HbA_1c≤9%)、C组(HbA_1c>9%)。对比三组患者的感觉神经受损程度以及电流阈值(CPT值)。结果A组的双侧正中神经-尺神经的无髓鞘纤维的CPT值明显低于B、C组(P<0.05)。C组的双侧正中神经-尺神经的粗有髓鞘纤维的CPT值明显高于A、B两组(P<0.05),A、B两组之间差异无统计学意义。B、C两组的左侧腓浅神经-腓深神经的细有髓鞘纤维的CPT值及无髓鞘纤维的CPT值明显高于A组(P<0.05),C组的右侧腓浅神经-腓深神经的无髓鞘纤维的CPT值明显高于A、B两组(P<0.05)。血糖控制未达标的2型糖尿病患者中三种不同亚群的感觉神经受损程度均明显高于血糖控制达标的2型糖尿病患者。结论实现对糖尿病患者血糖的优化控制,是有效阻止患者不同感觉神经亚群受损的重要保证。

Objective The correlation between glycated hemoglobin and damage of three different sensory nerve subsets in diabetes patients was investigated through evaluation of damage of three different sensory nerve subsets in type 2 diabetes patients. Methods 200 cases of type 2 diabetes patients were divided into three groups in accordance with HbA_1c value( A group: HbA_1c≤7. 5%,B group: 7. 5% < HbA_1c≤9%,C group: HbA_1c > 9%). Then damage extent of sensory nerve subsets and current threshold value( CPT value) of three groups were compared. Results The CPT value of unmyelinated fiber in bilateral median nerve-ulnar nerve of A group was lower than that of B group and C group( P < 0. 05). The CPT value of thick myelinated fibers in bilateral median nerve-ulnar nerve of C group was significantly higher than that of A group and B group( P < 0. 05),and no significant difference between group A and group B. The CPT value of unmyelinated fiber and fine myelinated fibersin in left superficial peroneal nerve-deep peroneal nerve of B,C group was significantly higher than A group( P < 0. 05). The CPT value of unmyelinated fiber in right superficial peroneal nerve-deep peroneal nerve of C group was significantly higher than A,B group( P < 0. 05). Conclusion The Degree of damage in three different subsets sensory nerve of glycemic control beyond standard type 2 diabetes patient was significantly higher than those glycemic control up to standard patient. The better glycemic control,crude sensory nerve myelinated fibers and unmyelinated fibers may benefit more.