糖尿病周围神经病变的相关因素分析

Analysis of Related Factors in Diabetic Peripheral Neuropathy

目的:分析糖尿病周围神经病变(DPN)的相关因素,为其早期预防和诊治提供必要帮助。方法:选择糖尿病患者125例纳入对照组,选择同期确诊为DPN的患者110例纳入DPN组。分析2组临床资料的差异性、DPN的相关因素,并通过神经传导速度检查分析DPN患者神经损伤的特点。结果:病程长、平均血糖波动幅度大的糖尿病患者更可能合并DPN(P<0.05);高密度脂蛋白水平高的糖尿病患者合并DPN的可能性较小(P<0.05)。DPN患者感觉神经异常比例明显高于运动神经(P<0.05)。年龄较大、病程较长的患者更容易出现尺神经和正中神经感觉神经异常(P<0.05),血糖波动幅度较大的患者更容易出现正中神经感觉异常(P<0.05)。结论:病程长、高密度脂蛋白低或平均血糖波动幅度大的糖尿病患者更容易出现周围神经病变,且应对年龄>45岁、病程>10年或平均血糖波动幅度>4 mmo/L的糖尿病患者,常规筛查神经传导速度,从而预防DPN的发生、发展。

Objective: Analyze the related factors of diabetic peripheral neuropathy(DPN) in order to provide necessary assistance for early prevention and diagnosis. Methods: We recruited 125 diabetic patients as the control group and, during the same time period, 110 patients with confirmed diagnoses of DPN as the DPN group. We analyzed the differences in clinical data and related factors of DPN between the two groups as well as the characteristics of nerve injury in patients with diabetic peripheral neuropathy by nerve conduction velocity examination. Results: Logistic regression analysis showed that patients with a long duration of diabetes were more likely to be complicated with DPN(P<0.05);diabetics with high levels of high-density lipoprotein were less likely to develop DPN(P<0.05). The proportion of sensory nerve abnormalities in DPN patients was significantly higher than that of motor nerves abnormalities(P<0.05). The proportion of sensory ulnar nerve and median nerve abnormalities was higher in older patients and those with a longer duration of diabetes(P<0.05). The proportion of median nerve damage was higher in patients with a larger mean amplitude of glycemic excursions(P<0.05). Conclusion: Diabetic patients who have longer disease duration, lower level of high-density lipoprotein, or larger mean amplitude of glycemic excursions are more likely to be complicated with peripheral neuropathy. Routine screening of nerve conduction velocity in diabetics >45 years of age, with >10 years disease course, or with MAGE >4 mmo/L is necessary to prevent the occurrence and development of diabetic peripheral neuropathy.