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目的:探讨腺苷钴胺对2型糖尿病周围神经病变(DPN)患者血清同型半胱氨酸(Hcy)水平的影响。方法:选择2014年1月~2015年3月期间我院内分泌科收治的74例糖尿病周围神经病变患者,根据随机数字表法将其随机分为两组,对照组予控制血糖等常规治疗,观察组联合应用腺苷钴胺注射液肌肉注射,治疗前后采用症状总评分法(TSS)对患者的神经症状进行评分,比较两组患者临床症状及血浆Hcy水平,并对患者的双侧胫总神经、腓总神经的运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)进行测定。结果:对照组患者治疗后血浆Hcy水平、TSS评分及胫神经、腓神经MNCV、SNCV与治疗前比较差异无统计学意义;观察组患者治疗后TSS评分中疼痛、感觉异常、灼热感、麻木及总评分均较治疗前明显降低;并且观察组患者血浆Hcy水平以及胫神经、腓神经MNCV、SNCV明显增快;观察组患者治疗总有效率为86.48%,明显高于对照组的64.86%;观察组有2例患者出现胃纳减退,不良反应发生率为5.41%。结论:腺苷钴胺治疗DPN可以明显降低血浆Hcy水平,改善神经传导速度及临床症状,提高临床疗效。
Objective: To investigate the effect of adenosylcobalamin on serum homocysteine (Hcy) level in patients with type 2 diabetic peripheral neuropathy (DPN). Methods: From January 2014 to March 2015, 74 patients with diabetic peripheral neuropathy admitted to Department of Endocrinology from January 2014 to March 2015 were randomly divided into two groups according to the random number table method. The control group was given conventional therapy such as blood sugar control. Group were given adenosine cobalamin injection intramuscularly before and after treatment with the total symptom score (TSS) of patients with neurological symptoms were scored, the clinical symptoms and plasma Hcy levels were compared between the two groups, and the patient’s bilateral tibial nerve , Motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of the common peroneal nerve were measured. Results: There was no significant difference in plasma Hcy level, TSS score, MNCV and SNCV between the control group and the pretreatment group, pain, abnormal sensation, burning sensation, numbness in the TSS score, The total score was significantly lower than before treatment; and the observation group patients with plasma Hcy levels and tibial nerve, peroneal nerve MNCV, SNCV was significantly faster; the observation group, the total effective rate was 86.48%, significantly higher than 64.86% of the control group; Two patients in the group showed decreased appetite. The incidence of adverse reactions was 5.41%. Conclusion: Adenosylcobalamin treatment of DPN can significantly reduce plasma Hcy levels, improve nerve conduction velocity and clinical symptoms, and improve clinical efficacy.