肿瘤坏死因子-α在糖尿病痛性神经病变患者中的表达及其意义

The expression level of TNF-αin patients with painful diabetic neuropathy

目的探讨糖尿病痛性神经病变(PDN)患者血清肿瘤坏死因子(TNF-α)的表达水平及意义。方法选取我院80例2型糖尿病患者,根据是否合并糖尿病周围神经病变及对患者的疼痛评分分为单纯糖尿病组(DM组,21例)、非痛性周围神经病变组(DPN组、44例)和痛性神经病变组(PDN组,15例);另选同期健康体检人群24例作为正常对照组(NC组)。ELISA测定各组TNF-α水平,分析TNF-α与各临床指标的相关性,Logistic回归分析PDN的影响因素。结果 NC组、DM组、DPN组、PDN组患者的TNF-α水平依次升高。[(33.62±5.03)vs(36.28±7.29)vs(48.33±5.91)vs(62.98±11.56),P<0.01]。Spearman相关分析显示,TNF表达水平与病程、年龄、吸烟、CRP、HbA1C呈正相关。多因素Logistic逐步回归分析显示TNF、CRP是PDN独立的危险因素。结论血清TNF-α水平在PDN患者中显著升高,是发生PDN的独立危险因素,这表明炎症反应参与了PDN的发生与发展。

Objective To investigate the expression level of TNF-αin patients with diabetic painful neuropathy(PDN).Methods A total of 80 patients with type 2 diabetes were divided into three groups according to the existence of DPN and the patients,VAS pain score:DM group(21 cases)、DPN group(44 cases)and PDN group(15 cases).Meanwhile,24 healthy subjects were selected as the normal control group(NC group).Serum level of TNF-αwas measured by enzyme linked immunosorbent assay(ELISA).The correlation between TNF-αand various clinical characteristics was analyzed.The risk factors of PDN patients were analyzed by Logistic regression.Results The expression of TNF-αin PDN group was higher than that in PDN group than that in DM group than that in NC group [(62.98±11.56)vs(48.33±5.91)vs(36.28±7.29)vs(33.62±5.03),P<0.01].Spearman correlation analysis showed that the level of TNF-αwas positively correlated with disease course,age,smoking,CRP and HbA1 C.Multivariate Logistic stepwise regression analysis showed that TNF-αand CRP were both independent risk factors for PDN.Conclusion Serum TNF-αwas significantly increased in patients with PDN,TNF-αwas an independent risk factor for PDN,indicating that inflammatory response is involved in the occurrence and development of PDN.