2型糖尿病患者周围神经传导速度有关因素分析

目的评价影响2型糖尿病患者周围神经传导速度的有关因素.方法对157例2型糖尿病患者和40例正常对照者进行周围神经传导速度测定,并就其与病程、尿白蛋白排泄和糖化血红蛋白(HbAlc)的关系进行分析.结果①在病程＜5年、5～10年、10～15年和＞15年的患者中,周围感觉神经电生理异常的发生率随病程的延长而显著增高,P＜0.05或0.01,而运动神经病变早期多不明显,仅在病程＞10年的患者中其神经传导速度才明显减慢;②在正常、微量和大量白蛋白尿,感觉神经电生理异常的发生率随尿白蛋白排泄的增加而增加,大量白蛋白尿患者周围运动神经波幅明显降低,传导速度显著减慢;③与正常对照组比较,HbA1c显著升高,P＜0.01;在病程相同的组内分析,与无神经病变者相比,伴神经病变者HbA1c明显升高,P＜0.05.结论糖尿病患者周围神经病变与病程、尿白蛋白排泄和血糖控制有关.

Analysis on factors related to peripheral nerve conduction velocity in patients with type 2 diabetes mellitus

Objective To analysis the factors relatedto peripheral nerve conduction velocity(PNCV)in type 2 diabetics. Methods PNCV was measured in 157 patients with type 2 diabeties mellitus and 40 control subjects,then relationships between PNCV and duration urinaryexcretion(UAE)and glycated hemoglobin Alc were analysed. Results ① Among 157 diabetic patients with duration less than 5 years,5～10 years,10～15 years and more than 15 years,abnormal rates of peripherial sensory nerve electrophysiology increased significantly with the prolongation of diabetic duration, but motor nerve conduction velocity decreased significantly only in patients with duration more than 10 years;② Among patients with normo,micro and macroalbuminuria,abnormal rates of peripheral sensory nerve electrophysiology increased significantly with the increase of UAE ,however obvious decreased amplitude and conduction velocity of motor nerve were detected only in patients with macroalbuminuria;③ Compared with control group, HbA1c increased markedly in diabetic patients , P <0.01;Among the intra group with same duration ,the HbA1c was higher in patients with peripheral neuropathy in comparison with those withoutperipheral neuropathy. Conclusion Diabetic peripheral neuropathy is related to the diabetic duration ,UAE and glucose control.