目的:研究高同型半胱氨酸血症(Hhcy)对2型糖尿病(DM)交感神经功能状态的影响.方法:选取2型糖尿病Hhcy患者22例,并以22例2型糖尿病非Hhcy患者作为对照,采用丹麦Keypoint.net肌电图仪通过皮肤交感反射(SSR)检测技术,对2组患者进行四肢SSR测定,记录并比较2组患者SSR波平均潜伏期、波幅及上肢-下肢SSR潜伏期比和波幅比差异.结果:Hhcy组和非Hhey组SSR潜伏期上肢分别为(1 593.11±149.85) ms、(1 539.75±149.22)ms(P＞0.05)；下肢分别为(2 795.86±415.24) ms、(2617.93+327.61) ms(P＜0.05).Hhcy组和非Hhcy组SSR波幅上肢分别为(1.03±0.38 )mY、(1.22±0.30)mV(P＜0.01)；下肢分别为(0.28±0.17) mV、(0.38±0.15 )mV(P＜ 0.01).2组上肢-下肢SSR波幅比Hhcy组较非Hhcy组增高(P＜0.01),而同侧上肢-下肢SSR潜伏期比2组差异无统计学意义.结论:Hh-cy可以加重2型DM交感神经损害程度,且有长度依赖性特点,而SSR检测是简单可行的手段.%Objective: To investigate effects of hyperhomocysteinemia(Hhcy)on the sympathetic nervous function in patients with type 2 diabetic mellitus(DM). Methods: Forty-four patients with type 2 DM were divided into two groups, Hhcy group (n=22) and non Hhcy (Nhhcy) group (n=22). Values of sympathetic skin reflex(SSR) were detected by Keypoint.net elec-tromyogram in four limbs of all patients, and average latencies, amplitudes and ratios of upper to lower limbs were compared between two groups. Results: The upper limb latencies of SSR were (1 593.11±149.85)ms and (1 539.75±149.22)ms for Hhcy group and Nhhcy group(P > 0.05). The lower limb latencies of SSR were (2 795.86±415.24)ms and (2 617.93±327.61)ms for Hhcy group and Nhhcy group(P < 0.05). The upper limb amplitudes of SSR were( 1.03±0.38)mV and( 122±0.30)rnV in Hhcy group and Nhhcy group {P < 0.01). The upper limb amplitudes of SSR were(0.28±0.17) mV and(0.38±0.15)mV in two groups {P < 0.01). The SSR amplitude ratio of ipsilateral upper and lower extremities was significantly higher in Hhcy group than that of Nhhcy group (P < 0.01). There was no significant difference in SSR latency ratio of ipsilateral upper and lower extremities between 2 groups. Conclusion: Hhcy may increase the damage of sympathetic nervous in patients with type 2 DM, which showed features of length dependence. Detection of SSR is a simple and feasible technique.
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