前列地尔联合鼠神经生长因子对2型糖尿病神经病变患者血清同型半胱氨酸、超敏C反应蛋白及抗氧化能力的影响

Effects of alprostadil combined with mouse nerve growth factor on serum homocysteine,hypersensitive C-reactive protein and antioxidant capacity in patients with type 2 diabetic neuropathy

目的:探讨前列地尔联合鼠神经生长因子对2型糖尿病神经病变患者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)及抗氧化能力的影响。方法:选取2016年4月至2019年4月太钢总医院内分泌科收治的128例2型糖尿病神经病变患者,男75例,女53例,年龄(61.13±8.92)岁,年龄范围为34~78岁,根据用药方法的不同将患者分成前列地尔组(n=37)、鼠神经生长因子组(n=42)及联合治疗组(n=49),对三组患者进行多伦多周围神经病变评分(TCSS)和视觉模拟评分(VAS);使用全功能诱发电位仪检测患者正中神经、胫骨神经及腓肠神经的感觉(SCV)和运动电位(MCV);采用酶联免疫吸附试验检测Hcy、hs-CRP及抗氧化指标丙二醛、超氧化物歧化酶(SOD)水平。结果:治疗后,联合治疗组TCSS、VAS[(3.15±0.84)分、(1.35±1.09)分]显著低于前列地尔组[(7.05±1.13)分、(2.13±0.42)分]和鼠神经生长因子组[(6.82±1.27)分、(2.05±0.36)分];联合治疗组正中神经、胫骨神经、下肢腓肠神经中SCV[(49.31±4.15)m/s、(49.15±4.03)m/s、(55.09±4.28)m/s]、MCV[(57.84±4.75)m/s、(47.85±4.13)m/s、(48.29±4.35)m/s]均高于前列地尔组[(45.81±3.71)m/s、(45.95±3.88)m/s、(44.07±3.69)m/s、(48.08±4.58)m/s、(39.14±3.04)m/s、(41.04±3.88)m/s]和鼠神经生长因子组[(44.92±3.59)m/s、(48.08±3.92)m/s、(49.27±4.12)m/s、(54.92±4.61)m/s、(43.55±3.92)m/s、(44.27±3.69)m/s];联合治疗组Hcy、hs-CRP、丙二醛及SOD水平[(18.73±3.62)μmol/L、(6.21±1.06)mg/L、(4.09±0.62)mmol/ml、(55.77±28.83)nU/ml]显著低于前列地尔组[(21.09±3.88)μmol/L、(9.52±1.14)mg/L、(6.01±0.85)mmol/ml、(76.17±30.05)nU/ml]和鼠神经生长因子组[(22.27±4.14)μmol/L、(10.04±1.39)mg/L、(6.14±0.88)mmol/ml、(78.34±29.91)nU/ml],差异有统计学意义(P<0.05)。结论:前列地尔联合鼠神经生长因子对2型糖尿病神经病变具有较好的缓解作用,联合治疗效果显著优于单独用药效果,值得在临床上推广应用。

Objective To investigate the effects of alprostadil combined with rat nerve growth factor on serum homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP)and antioxidant capacity in patients with type 2 diabetic neuropathy.Methods A retrospective study was performed on 128 patients with type 2 diabetic neuropathy who were admitted from April 2016 to April 2019,75 males and 53 females,aged(61.13±8.92)years,and the age range was 34 to 78 years.The patients were divided into alprostadil group(n=37),rat nerve growth factor group(n=42),and combined treatment group(n=49)according to different medication methods.Three groups of patients were treated with Toronto peripheral neuropathy score(TCSS)and visual simulation score(VAS);the sensory(SCV)and motor potential(MCV)of the median,tibial,and gastrocnemius nerves were measured using a full-function evoked potentiometer;Hcy,hs-CRP and antioxidant indicators malondialdehyde and superoxide dismutase(SOD)levels.Results After treatment,the TCSS and VAS of the combined treatment group[(3.15±0.84)points,(1.35±1.09)points]were significantly lower than those of the alprostadil group[(7.05±1.13)points,(2.13±0.42)points],and the rat nerve Growth factor group[(6.82±1.27)points,(2.05±0.36)points];SCV in median nerve,tibia nerve,and lower gastrocnemius nerve of the combined treatment group[(49.31±4.15)m/s,(49.15±4.03)m/s,(55.094.28)m/s],MCV[(57.84±4.75)m/s,(47.85±4.13)m/s,(48.29±4.35)m/s]were all higher than the alprostadil group[(45.81±3.71)m/s,(45.95±3.88)m/s,(44.07±3.69)m/s,(48.08±4.58)m/s,(39.14±3.04)m/s,(41.04±3.88)m/s]and rat nerve growth factor group[(44.92±3.59)m/s,(48.08±3.92)m/s,(49.27±4.12)m/s,(54.92±4.61)m/s,(43.55±3.92)m/s,(44.27±3.69)m/s];Hcy,hs-CRP,malondialdehyde,and SOD levels in the combined treatment group[(18.73±3.62)μmol/L,(6.21±1.06)mg/L,(4.09±0.62)mmol/ml,(55.77±28.83)nU/ml]are significantly lower than the alprostadil group[(21.09±3.88)μmol/L,(9.52±1.14)mg/L,(6.01±0.85)mmol/ml,(76.17±30.05)nU/ml]and rat nerve growth factor group[(22.27±4.14)μmol/L,(10.04±1.39)mg/L,(6.14±0.88)mmol/ml,(78.34±29.91)nU/ml],the difference was statistically significant(P<0.05).Conclusion Alprostadil combined with mouse nerve growth factor has a better effect on the remission of type 2 diabetic neuropathy,and the effect of combined treatment is significantly better than that of single drug,which is worthy of reference in clinical practice.