糖尿病性周围神经病变2型糖尿病患者相关临床指标和危险因素分析

摘要

目的：探讨发生糖尿病性周围神经病变（DPN）的2型糖尿病患者相关临床指标的变化和危险因素，并分析其可能机制。方法对205例2型糖尿病患者进行肌电图电生理检查，分为DPN组（122例）和无糖尿病性周围神经病变（NDPN）组（83例）。观察DPN发生率；记录患者性别、年龄、病程、血压和体质量指数；检测患者糖化血红蛋白、尿微量清蛋白/尿肌酐（尿A/C）、血肌酐、尿酸、三酰甘油、总胆固醇等相关临床指标，并进行统计学分析和多因素logistic回归模型分析。结果 DPN发生率为59.5%（122/205）。DPN组患者年龄较NDPN组大，收缩压、血肌酐、尿A/C较NDPN组高，差异均有统计学意义（t=-3.497、-3.057、-2.600、-2.920，P=0.001、0.003、0.010、0.004）。DPN组患者年龄、尿A/C与DPN的发生呈显著正相关（OR=1.039、1.005，P=0.024、0.010）。结论2型糖尿病患者DPN发生率高，年龄、尿A/C是发生DPN的危险因素。%Objective To investigate the correlated clinical parameters and the risk factors about diabetic peripheral neuropathy(DPN) of patients with type 2 diabetes mellitus(T2DM),and to analyze the possible mechanism. Methods A total of 205 hospitalized patients with T2DM were examined by electrophysiology and divided into DNP group(n=122) and non DPN group (NDPN group,n=83). The incidence of DPN were observed,the sex,age,course of disease,blood pressure,body mass index were recorded,and their correlated clinical parameters like glycosylated hemoglobin(HbAlc),uric microalbuminuria creatinine ratio (urinary A/C),serum creatinine,uric acid,triglyceride(TG),total serum cholesterol(TC) were detected. The resucts were analyzed by multivariate Logistic regression statistically. Results The incidence rate of DPN was 59.5%(122/205). Compared with the NDPN group,the DPN group had older age(t=-3.497,P=0.001),higher systolic blood pressure(t=-3.057,P=0.003),higher serum creatinine(t=-2.600,P=0.010) and uric A/C(t=-2.920,P=0.004),and the differences were all statistically significant(P<0.05). Multivariate Logistic regression analysis showed that the incidence of DPN was positively correlated with the age (OR=1.039, P=0.024) and urinary A/C(OR=1.005,P=0.010) in the DPN group. Conclusion The incidence of DPN in T2DM patients is high,and age and urinary A/C are the risk factors.