论文部分内容阅读
背景糖尿病周围神经病变的发生是多因素综合影响的结果,其中高血糖是最重要的影响因素已形成共识。目的分析糖尿病周围神经病变与各影响因素之间的关系,进一步阐明严格控制血糖的重要性。设计以诊断为依据的横断面研究。地点和对象收集1999-06/2001-06在本院内分泌科住院治疗患者120例,均符合1999年制订的糖尿病诊断标准。方法测定120例糖尿病患者周围神经传导速度,与各影响因素进行逐步回归分析,并以糖化血红蛋白(HbA1c)不同切点进行分组,将各周围神经传导速度进行t检验。主要观察指标糖尿病患者各周围神经传导速度、病程、空腹血糖、餐后2h血糖、年龄、总胆固醇、三酰甘油、HbA1c、果糖胺、C肽、餐后2hC肽、以及24h尿蛋白总量。结果各影响因素中,HbA1c有4项显著相关,其次为年龄(3项),再次为空腹血糖和病程(2项),当HbA1c达到6.8时,开始出现周围神经传导速度的显著差异,HbA1c超过8.0时,所有的神经传导速度均出现明显差异。若去除病程和年龄因素后,HbA1c达到9.0时,所有神经传导速度方才出现显著差异。结论糖尿病周围神经病变与多种影响因素有关,相关性最强的是HbA1c,其次,病程和年龄也起到了非常重要的作用。
Background The incidence of diabetic peripheral neuropathy is the result of a combination of multiple factors, of which hyperglycemia is the most important influencing factor has been reached consensus. Objective To analyze the relationship between diabetic peripheral neuropathy and various influencing factors and further elucidate the importance of strict control of blood glucose. Design a diagnostic-based cross-sectional study. Location and Subjects: 120 patients were admitted to Department of Endocrinology in our hospital from June 1999 to June 2001, all of whom were in line with the diagnostic criteria of diabetes developed in 1999. Methods Peripheral nerve conduction velocity was measured in 120 patients with diabetes mellitus, and each factor was analyzed by stepwise regression analysis. HbA1c was used to divide the peripheral nerve conduction velocity into t-test. MAIN OUTCOME MEASURES Peripheral nerve conduction velocity, duration of disease, fasting blood glucose, postprandial 2h blood glucose, age, total cholesterol, triglyceride, HbA1c, fructosamine, C peptide, postprandial 2h peptide, and total urinary protein in 24 hours were measured. Results Among the influential factors, there were 4 significant correlations among HbA1c, followed by age (3), again fasting blood glucose and duration (2). When HbA1c reached 6.8, a significant difference in peripheral nerve conduction velocity started to occur. HbA1c exceeded 8.0, all the nerve conduction velocity were significantly different. If the duration of disease and age were removed, all neurotransmitters had a significant difference when HbA1c reached 9.0. Conclusions Diabetic peripheral neuropathy is associated with many influential factors, with the strongest correlation being HbA1c. Second, duration and age play a very important role.