2型糖尿病患者C-反应蛋白与周围神经病变的关系

Relationship between C-reactive protein and peripheral neuropathy in type 2 diabetic patients

目的 :分析2型糖尿病(T2DM)患者C-反应蛋白(CRP)与周围神经病变(DPN)的关系,为DPN的管理提供依据。方法 :2017年1月—12月,共收治的T2DM患者102例,诊断DPN,检测CRP值,进行肌电图检查、多伦多临床评分系统的评估。结果 :确诊存在DPN 50例,伴神经病变患者的CRP值为(3.3±1.5)mg/L,高于未合并神经病变者(2.1±1.1)mg/L(P <0.05)。以CRP截断值2.4 mg/L作为DPN的筛查标准,其灵敏度为76.0%、特异度为78.8%、符合率为77.5%。正中神经、尺神经、腓总神经的运动和感觉神经传导速度与CRP值均呈负相关性(P <0.05);而患者多伦多临床评分与CRP值存在中等正相关性(r=0.524, P <0.05)。结论:T2DM患者CRP值与DPN的发生、严重程度密切,可作为DPN筛查、诊断、疾病严重程度判断的指标。

Objective: To analyze the relationship between C-reactive protein (CRP) and peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus and to provide evidence for DPN management. Methods: A total of 102 patients with type 2 diabetes hospitalized from January to December, 2017 were involved in this study. Their peripheral neuropathy was diagnosed, CRP level was determined and electromyography examination and evaluation of Toronto clinical scoring system (TCSS) were performed. Results: Fifty cases were diagnosed as DPN, in which the level of CRP in patients with DPN was higher than that without DPN [(3.3±1.5) mg/L vs (2.1±1.1) mg/L, P<0.05]. When the truncated value 2.4 mg/L of CRP was taken as a screening criterion for DPN, its sensitivity, specificity and coincidence rate were 76.0%(38/50), 78.8%(41/52) and 77.5%(79/102), respectively. There were negative correlation between the conduction velocity of both motor nerve and sensory nerve of median nerve, ulnar nerve and common peroneal nerve and CRP level (P<0.05) and moderate positive correlation between Toronto clinical score and CRP level (r=0.524, P<0.05). Conclusion: CRP level is closely related to the occurrence and severity of DPN in type 2 diabetic patients, which can be used as an indicator for the screening, diagnosis and evaluation of severity of peripheral neuropathy.