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目的探讨糖尿病周围神经病变(DPN)的神经损害特点及相关危险因素。方法根据神经传导速度(NCV)将T2DM患者分为DPN组和无DPN(NDPN)组,分析各组糖尿病病程、BP、FPG、HbA1c、BMI、血脂,以及体感诱发电位等。结果年龄、病程是DPN发生的危险因素(OR=1.096、1.121,P<0.05)。SBP、FPG、TG、TC与DPN呈正相关,但差异无统计学意义(P>0.05)。HDL-C为DPN的保护因素(OR=2.013,P<0.05)。粗有髓鞘神经纤维及细有髓鞘神经纤维病变组HDL-C水平下降(P<0.05),且下肢细有髓神经纤维是DPN的好发部位。结论糖尿病患者增龄、病程长是DPN的危险因素,HDL-C降低与DPN发生发展密切相关。
Objective To investigate the characteristics of nerve damage and related risk factors of diabetic peripheral neuropathy (DPN). Methods According to the nerve conduction velocity (NCV), T2DM patients were divided into DPN group and non-DPN (NDPN) group. The course of diabetes, BP, FPG, HbA1c, BMI, blood lipid and somatosensory evoked potentials were analyzed. Results Age and duration were the risk factors of DPN (OR = 1.096,1.121, P <0.05). SBP, FPG, TG, TC and DPN were positively correlated, but the difference was not statistically significant (P> 0.05). HDL-C is a protective factor for DPN (OR = 2.013, P <0.05). The levels of HDL-C in the myelinated nerve fibers and the myelinated nerve fibers decreased (P <0.05), and the fine myelinated nerve fibers in the lower limbs were the predilection sites for DPN. Conclusion The age of diabetic patients and the longer course of disease are the risk factors of DPN. The decrease of HDL-C is closely related to the occurrence and development of DPN.