2型糖尿病周围神经病变患者NSE、炎症状况及其诊断价值分析

Analysis of NSE, inflammation and diagnostic value in patients with type 2 diabetic peripheral neuropathy

目的:探讨2型糖尿病周围神经病变患者的NSE和炎症状况,分析其诊断价值.方法:回顾性分析2015年1月~2017年7月期间在我院接受治疗的140例2型糖尿病患者和进行体检的60例健康者的诊疗情况.其中70例患者发生周围神经病变,作为DPN组,另70例单纯糖尿病者作为DM组.比较三组的总胆固醇(TC)、三酰甘油(TG)、空腹血糖(FPG)、2h血糖(2hPG)、高密度脂蛋白(HDL-C)和低密度脂蛋白(LDL-C)等生化指标,神经元特异性烯醇化酶(NSE)和白细胞介素-6(IL-6)、、白细胞介素-1β(IL-1β)、炎性细胞因子肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)等炎性因子,并在2型糖尿病患者中以是否发生糖尿病周围神经病变为因变量进行多因素Logistic 回归分析.结果:DPN组和DM组的FPG和2hPG均明显高于健康组,差异有统计学意义.DPN组的TC和LDL-C明显高于健康组,差异有统计学意义.三组的TG和HDL-C相比,差异无统计学意义.DPN组和DM组的NSE、IL-6、IL-1β、TNF-α和CRP均明显高于健康组,差异有统计学意义;DPN组的NSE、IL-6和TNF-α明显高于DM组,差异有统计学意义.DPN组和DM组的IL-1β和CRP相比,差异无统计学意义.多因素Logistic回归分析显示,NSE、IL-6和TNF-α对2型糖尿病有无合并周围神经病变有较好的独立作用.结论:2型糖尿病周围神经病变患者NSE、IL-6和TNF-α等指标显著升高,且可作为2型糖尿病周围神经病变的诊断指标.

Objective To investigate the NSE and inflammatory status of patients with type 2 diabetic peripheral neuropathy and analyze their diagnostic value. Methods A retrospective analysis of the diagnosis and treatment of 140 patients with type 2 diabetes and 60 healthy persons undergoing physical examination from January 2015 to July 2017 in our hospital. There were 70 cases of peripheral neuropathy, as DPN group, and 70 cases of simple diabetes as DM group. The biochemical indexes such as TC, TG, FPG, 2hPG, LDL-C and HDL-C, NSE and IL-6, IL-1β, TNF-α, CRP and other inflammatory factors were compared in the three groups, and multiple factor Logistic regression analysis was carried out in patients with type 2 diabetic patients with diabetic peripheral neuropathy as a dependent variable. Results FPG and 2hPG in DPN group and DM group were significantly higher than those in healthy group. The TC and LDL-C in DPN group were significantly higher than those in healthy group. There was no significant difference between the three groups of TG and HDL-C. The NSE, IL-6, IL- 1β, TNF-α and CRP in DPN group and DM group were significantly higher than those in the healthy group, and the difference was statistically significant. The NSE, IL-6 and TNF-α of the DPN group were significantly higher than those in the group, and the difference was statistically significant. There was no significant difference in IL-1β and CRP between DPN group and DM group. Multiple factor Logistic regression analysis showed that NSE, IL-6 and TNF-α had a good independent effect on type 2 diabetes with peripheral neuropathy. Conclusion The levels of NSE, IL-6 and TNF-α in type 2 diabetic peripheral neuropathy patients were significantly increased, and they could be used as diagnostic indexes for type 2 diabetic peripheral neuropathy.