高脂血症与糖尿病周围神经病变的关系及其干预研究

摘要

Objective To study the relationship between lipid metabolism disorders and diabetic peripheral neuropathy (DPN) diabetic peripheral neuropathy,and to observe the influence of Traditional Chinese Medicine.Methods 200 cases with type 2 diabetes patients of the Second People's Hospital from August 2010 to August 2012 were chosed,according to the clinical symptoms and nerve electrophysiology results are divided into two groups,100 cases of peripheral neuropathy (DPN group) and 100 cases of the peripheral neuropathy group (NDPN group); the 200 cases of type 2 diabetes patients serum lipid metabolism each index test results were retrospectively analyzed.Results The serum triglyceride (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (ApoB) level of DPN group [(2.4±2.1),(5.6±1.7),(3.7±0.9) mmol/L,(1.2±0.9) g/L] patientswere significantly higher than NDPN group [(1.5±0.9),(3.1±1.9),(2.1±0.8) mmol/L,(0.7±0.3) g/L] (P ＜ 0.05); Islet rope sensitive index (homa-ir) patients for DPN[(1.4±0.7)]was significantly lower than the NDNP group[(2.7±0.6)] (P ＜ 0.05).After the treatment NDPN group 59 patients markedly improved,effective 29 cases shall be null and void in 12 cases,the total effective rate was 88.0％,DPN group after treatment,the clinical symptoms and signs were improved obviously (P ＜0.05).Conclusion The lipid metabolism disorders in patients with type 2 diabetes is an important risk factor for concurrent DPN,lipid metabolism disorders may be involved in the occurrence of diabetic neuropathy development process.Chinese herbal medicine in treating diabetic peripheral neuropathy curative effect affirmation.%目的 探讨脂质代谢紊乱与糖尿病外周神经病变(DPN)的关系并观察中药对其影响.方法 选择广东省第二人民医院2010年8月～2012年8月收治入院的2型糖尿病住院患者200例,根据临床症状及神经电生理检查结果分为两组,周围神经病变组100例(DPN组)和非周围神经病变组100例(NDPN组)；对该200例2型糖尿病患者血清脂质代谢各项指标检测结果进行回顾性分析.结果 DPN组的三酰甘油(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白B(ApoB)水平为(2.4±2.1)、(5.6±1.7)、(3.7±0.9) mmol/L、(1.2±0.9)g/L,比NDPN患者的[(1.5±0.9)、(3.1±1.9)、(2.1 ±0.8) mmol/L、(0.7±0.3)g/L均显著增高(均P＜0.05)；胰岛素敏感指数(HOMA-IR)DPN组患者为(1.4±0.7),明显低于NDNP组的(2.7±0.6),差异有统计学意义(P＜0.05).疗程结束后NDPN组100例患者中显效59例,有效29例,无效12例,总有效率88.0％;DPN组治疗后临床症状和体征均得到明显改善,与治疗前比较差异有统计学意义(P＜ 0.05).结论 脂质代谢紊乱是2型糖尿病患者并发DPN的重要危险因素,脂质代谢紊乱可能参与糖尿病神经病变的发生发展过程.中药治疗糖尿病周围神经病变疗效肯定.