甲钴胺对糖尿病周围神经病变的治疗效果及对血浆同型半胱氨酸水平的影响

The Treatment Effect of Mecobalamin on Diabetic Peripheral Neuropathy and the Effects on the Plasma Homocysteine Level

目的:观察甲钴胺对糖尿病周围神经病变的治疗效果以及对血浆同型半胱氨酸(Hcy)水平的影响。方法 :选择我院2015年10月-2016年9月收治的80例糖尿病患者作为研究对象,根据是否合并周围神经病变分为单纯糖尿病组42例与糖尿病合并周围神经病变组38例。单纯糖尿病组给予常规降血糖治疗及维生素B12治疗,糖尿病合并周围神经病组在单纯糖尿病组基础上给予甲钴胺(500μg/d)肌注。两组均治疗14周。另选择同时期内在我院体检的30例健康者作为健康对照组。以健康对照组血清Hcy水平为对照,比较单纯糖尿病组与糖尿病合并周围神经病变组治疗前后的Hcy水平变化情况。结果 :治疗前单纯糖尿病组和糖尿病合并周围神经病变组血清Hcy水平均显著高于健康对照组(P<0.05),糖尿病合并周围神经病变组血清Hcy水平显著高于单纯糖尿病组(P<0.05)。经治疗,两组血清Hcy水平仍显著高于健康对照组(P<0.05),但单纯糖尿病组与糖尿病合并周围神经病变组无统计学差异(P>0.05)。糖尿病合并周围神经病变组中显效28例,有效7例,无效3例,治疗有效率为92.11%。结论 :采用甲钴胺肌内注射对糖尿病周围神经病进行治疗,可以降低Hcy含量,能够缓解周围神经病症状。

Objective:To observe the therapeutic effect of mecobalamin on diabetic peripheral neuropathy and on the plasma homocysteine(Hcy) level of influence. Methods:80 cases of diabetic patients in our hospital from October 2015 to September 2016 were selected as the research object. The patients were divided into simple diabetes mellitus group(42 cases) and diabetic peripheral neuropathy group(38 cases) according to whether the peripheral neuropathy was accompanied or not. Simple diabetes mellitus group was received routine hypoglycemic treatment and vitamin B12, diabetic peripheral neuropathy group was given by intramuscular injection with mecobalamin(500 g/d) on the basis of simple diabetic group. The two groups were treated for 14 weeks. In addition, a total of 30 healthy people were selected as the healthy control group. The serum Hcy levels of healthy control group were regarded as comparison, and the changes of Hcy levels of simple diabetic group and diabetic peripheral neuropathy group were compared before and after treatment. Results:Before treatment, the serum Hcy levels of simple diabetic group and diabetic peripheral neuropathy were significantly higher than those in healthy control group(P<0.05), the serum Hcy level of diabetic peripheral neuropathy were significantly higher than the simple diabetes group(P<0.05). After treatment, the serum Hcy level of the two groups was still significantly higher than that of the healthy control group(P<0.05), but there was no significant difference between the simple diabetes group and the diabetic peripheral neuropathy group(P>0.05). In the diabetic peripheral neuropathy group, 28 cases were markedly effective, 7 cases were effective, 3 cases were ineffective, the effective rate was 92.11%. Conclusion:Intramuscular injection of mecobalamin in treatment of diabetic peripheral neuropathy can reduce the content of Hcy, and alleviate the symptoms of peripheral neuropathy.