糖尿病周围神经病变足底压力变化及其与神经传导、感觉电流阈值和炎症因子的关系

Plantar pressure changes in diabetic peripheral neuropathy and its relationship with nerve conduction,sensory current thresholds and inflammatory factors

目的探究糖尿病周围神经病变(DPN)足底压力变化及其与神经传导、感觉电流阈值和炎症因子的关系。方法纳入2型糖尿病合并DPN患者590例,按照是否患有糖尿病足分为对照组(未发生糖尿病足,n=320)和观察组(糖尿病足,n=270)。另纳入同期体检健康人群为空白组(n=150)。比较各组空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、血脂、足底不同区域峰值压力、运动/感觉神经传导速度(NCV)、感觉电流阈值(CPT)、炎症因子[白细胞介素(IL)-1β、IL-10、肿瘤坏死因子-α(TNF-α)和巨噬细胞炎性蛋白-1α(MIP-1α)]水平。分析足底压力变化与神经传导、感觉电流阈值和炎症因子的相关性。结果空白组、对照组、观察组足底不同区域峰值压力、FBG、2 hPG、IL-1β、IL-10、TNF-α、MIP-1α、HbA1c、CPT水平依次升高,NCV依次降低(P<0.05)。Pearson相关性分析显示,IL-1β、IL-10、NCV、CPT、TNF-α和MIP-1α与不同区域足底压力均呈正相关(P<0.05)。结论DPN患者足底峰值压力升高,与神经传导、感觉电流阈值和炎症因子密切相关,可为临床提供参考。

Aim To investigate the plantar pressure changes in diabetic peripheral neuropathy(DPN)and its relationship with nerve conduction,sensory current thresholds and inflammatory factors.Methods 590 cases with type 2 diabetes mellitus complicated with DPN were included and divided into a control group(no diabetic foot,n=320)and an observation group(diabetic foot,n=270)according to whether they had a diabetic foot or not.Another healthy population with physical examination at the same time was included as a blank group(n=150).Fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),glycated hemoglobin(HbA1c),blood fat,peak pressures in different areas of the plantar foot,motor/sensory nerve conduction velocity(NCV),current sensory threshold(CPT),and levels of inflammatory factors[interleukin-1β(IL-1β),IL-10,tumor necrosis factor-α(TNF-α)and macrophage inflammatory protein-1α(MIP-1α)]were compared in each group.The correlation of plantar pressure changes with nerve conduction,sensory current thresholds,and inflammatory factors was analyzed.Results Peak plantar pressure,FBG,2 hPG,IL-1β,IL-10,TNF-α,MIP-1α,HbA1c and CPT levels in different regions of the plantar foot in the blank,control,and observation groups were sequentially increased,and NCV was sequentially decreased(P<0.05).Pearson correlation analysis showed that IL-1β,IL-10,NCV,CPT,TNF-αand MIP-1αwere positively correlated with plantar pressure in different areas of the plantar foot(P<0.05).Conclusion Elevated peak plantar pressures in patients with DPN are closely related with nerve conduction,sensory current thresholds,and inflammatory factors,and may provide a clinical reference.