气虚血瘀型糖尿病周围神经病变的相关性分析

Correlation Study on Diabetic Peripheral Neuropathy with Qi-deficiency and Blood-stasis Type

目的:探究糖化血红蛋白(HbA1C)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)、血清总胆固醇(TC)、甘油三酯(TG)与气虚血瘀型糖尿病周围神经病变(DPN)的相关性。方法:选取气虚血瘀型DPN患者50例。采集血清测定糖化血红蛋白、C反应蛋白、同型半胱氨酸、血清总胆固醇、甘油三酯,通过肌电图(EMG)采集腓总神经运动传导速度,通过病史采集及体格检查得出TCSS评分。以TCSS评分为因变量的相关性分析采用有序Logistic回归分析,以神经传导速度为因变量的相关性分析采用多重线性回归。结果:有序Logistic回归分析表明同型半胱氨酸与TCSS评分呈正相关(P<0.05);多重线性回归表明糖化血红蛋白及同型半胱氨酸与腓总神经运动传导速度呈负相关(均P<0.05),两因素间无共线性,且同型半胱氨酸的影响大于前者。结论:糖化血红蛋白及同型半胱氨酸与DPN的发生发展密切相关,可为临床对DPN的早期诊断与治疗提供依据。

Objective To explore the correlation between hemoglobin A1c(HbA1c),C-reactive protein(CRP),homocysteine(Hcy),total cholesterol(TC),triglyceride(TG)and diabetic peripheral neuropathy(DPN)with qi deficiency and blood stasis.Methods 50 patients with DPN with qi-deficiency and blood-stasis type were selected from the inpatient department of endocrinology,Yueyang Hospital of Traditional Chinese Medicine.Serum samples were collected for the determination of HbA1c,CRP,Hcy,TC and TG.Total peroneal MCV was collected by EMG,and TCSS score was obtained by history collection and physical examination.The correlation analysis with TCSS score as the dependent variable used ordered Logistic regression analysis,and the correlation analysis with nerve conduction velocity as the dependent variable used multiple linear regression analysis.Results Orderly Logistic regression analysis showed that homocysteine was positively correlated with TCSS score(P<0.05).Multiple linear regression showed that HbA1c and homocysteine were negatively correlated with peroneal nerve conduction velocity(P<0.05 for both),and there was no collinearity between the two factors,and the effect of homocysteine was greater than that of the former.Conclusion HbA1c and Hcy are closely related to the occurrence and development of DPN,which may provide evidence for the early diagnosis and treatment of DPN in clinic.