Ⅱ型糖尿病周围神经病变的相关危险因素多中心调查

Multicenter study of the risk factors for peripheral neuropathy of type Ⅱ diabetic

目的了解Ⅱ型糖尿病患者周围神经病变的患病情况并评估发生的危险因素。方法调查入选1 673例住院Ⅱ型糖尿病患者临床资料,根据是否存在糖尿病周围神经病变(DPN)分为合并DPN组(DPN组,n=913)与未合并DPN组(NDPN,n=760),比较两组患者各项指标差异,并进行多因素Logistic回归分析。结果 DPN组糖尿病病程、SBP、FINS、HbAlc、Scr等指标明显高于NDPN组(P<0.05);2hC-P值明显低于NDPN组(P<0.05);DPN组合并DR、合并DN患者明显多于NDPN组,差异有统计学意义(P<0.05)。Logistic回归分析显示,糖尿病病程、SBP、HbAlc、2hC-P、Scr、合并DR、合并DN是DPN发生的独立危险因素。结论糖尿病病程、收缩压、糖化血红蛋白、血肌酐、餐后2hC肽、合并视网膜病变、合并糖尿病肾病是Ⅱ型糖尿病周围神经病变发生的独立危险因素,积极控制上述危险因素,可有效防治DPN。

Objective To understand the prevalence of peripheral neuropathy in patients with type Ⅱ diabetes and assess the risk factors. Methods 1 673 cases of hospitalized patients with type II diabetes were investigated,according to whether there existed DPN,DPN group（ n = 913） and non-DPN group（ n = 760） were divided. Indexes of the two groups were analyzed by multi-factor logistic regression. Results The course of DPN group,SBP、FINS、HbAlc、Scr were obviously higher than that of the NDPN group（ P〈0. 05） The value of 2 hC-P was obviously lower than that of the NDPN group（ P〈0. 05）. The number of patients of DPN group combined with DR,and/or DN was obviously more than that of the NDPNgruop,with significant difference（ P〈0. 05）. Logistic regression analysis showed that diabetes duration,FINS,HbAlc,2 hC-P,Scr,combined retinopathy and diabetic nephropathy were independent risk factors for the development of DPN. Conclusions Diabetes duration,the course of diabetes,glycosylated hemoglobin,serum creatinine,C peptide 2 hours after meal,combined retinopathy and diabetic nephropathy were independent risk factors for peripheral neuropathy in type Ⅱ diabetes. Actively controlling the above risk factors could effectively prevent and control DPN.