血清铜蓝蛋白和铁蛋白在糖尿病周围神经病变中的水平研究

Study on the level of serum ceruloplasmin and ferritin in diabetes peripheral neuropathy

目的研究血清铜蓝蛋白和铁蛋白在糖尿病周围神经病变(DPN)中的水平变化及二者联合检测对DPN的诊断价值。方法选择2021年10月—2022年10月在本院收治的的2型糖尿病(T2DM)患者作为研究对象,依据诊断标准共纳入DPN组60例,T2DM组60例,另取同期体检健康者设为正常对照组(NC组)60名。测定DPN组、T2DM组及NC组血清铜蓝蛋白检测、血清铁蛋白、空腹血糖、糖化血红蛋白指标变化,肌电图测定腓浅神经感觉传到速度、腓肠神经感觉传导速度、腓总神经运动传导速度和胫神经传导速度用以明确DPN,SPSS 23.0软件对三组人群铜蓝蛋白和铁蛋白检测结果进行组间比较,spearman相关分析明确铜蓝蛋白、铁蛋白二者关系及其与DPN指标之间的相关性,ROC曲线分析铜蓝蛋白、铁蛋白对DPN的预测价值。结果DPN组铜蓝蛋白和铁蛋白高于T2DM组和NC组,并且T2DM组铜蓝蛋白和铁蛋白也高于NC组。铜蓝蛋白和铁蛋白二者正相关,铜蓝蛋白、铁蛋白与腓浅神经感觉传到速度、腓肠神经感觉传导速度、腓总神经运动传导速度和胫神经传导速度存在负相关。铜蓝蛋白的AUC为0.701,铁蛋白的AUC为0.903二者联合诊断效能较高。结论铜蓝蛋白和铁蛋白在DPN中水平升高,铜蓝蛋白和铁蛋白联合检测对DPN具有早期诊断价值。

Objective To study the changes of serum ceruloplasmin and ferritin levels in DPN and the diagnostic value of their combined detection for DPN.Methods Patients with type 2 diabetes mellitus(T2DM)those were admitted to our hospital from October 2021 to October 2022 were selected as the research objects.According to the diagnostic criteria,a total of 60 cases were included in the DPN group and 60 cases in the T2DM group,and 60 healthy people were selected as the normal control group(NC group).Serum ceruloplasmin,serum ferritin,fasting blood glucose and glycosylated hemoglobin were measured in DPN group,T2DM group and NC group.Electromyography was used to determine the sensory transmission velocity of superficial peroneal nerve,sensory conduction velocity of sural nerve,motor conduction velocity of common peroneal nerve and tibial nerve conduction velocity to confirm DPN.SPSS 23.0 software was used to compare the results of ceruloplasmin and ferritin among the three groups.Spearman correlation analysis was used to determine the relationship between ceruloplasmin and ferritin and their correlation with DPN indicators.ROC curve was used to analyze the predictive value of ceruloplasmin and ferritin for DPN.Results The levels of ceruloplasmin and ferritin in DPN group were higher than those in T2DM group and NC group,and those in T2DM group were also higher than those in NC group.Ceruloplasmin and ferritin are positively correlated,while ceruloplasmin and ferritin were negatively correlated with superficial peroneal nerve sensory transmission velocity,sural nerve sensory transmission velocity,common peroneal nerve motor transmission velocity and tibial nerve transmission velocity.The AUC of ceruloplasmin was 0.701,and the AUC of ferritin was 0.903.The combined diagnostic efficacy of the two methods was higher.Conclusions The levels of ceruloplasmin and ferritin increased in DPN.The combined detection of ceruloplasmin and ferritin is of early diagnostic value for DPN.