糖尿病神经病变及其影响因素分析

目的 探讨糖尿病周围神经病病（DPN）的影响因素。方法 应用肌电图仪测定了156例糖尿病患者的正中神经、尺神经、腓总神经、胫后神经的感觉及运动神经传导速度（SNCV、MNCV），同时测定了血糖、糖化血红蛋白（HbA1c）、血脂、尿白蛋白排泄率（UAER）及血液流变学等。结果 神经传导速度（NCV）总异常率为58．3％，SNCV与MNCV异常率分别为62．9％和56．5％（P＜0．01），上肢与下肢NCV异常率分别为57．5％和62．7％（P＜0．05）；并发现随病程延长，NCV异常率逐渐增加，NCV与HbA1c、餐后血糖（PBG）、UAER呈显著负相关，与空腹血糖（FBG）无明显相关；伴NCV异常组红细胞聚集指数及低切变率明显高于NCV正常组。结论 DPN是多种因素综合作用的结果，应及早防治，综合治疗。

Analysis of associated factors of diabetic neuropathy in diabetes mellitus patients

Objective　To study diabetic neuropathy and its associated factors in diabetes mellitus patients.Methods　Sensory and motor nerve conduction velocity (SNCV、MNCV)of median nerve、cubital nerve、common peroneal nerve and post-tibial nerve were measured by electromyogram instrument in 156 diabetic patients. Fasting blood glucose(FBG)、postprandial blood glucose(PBG)、hemoglobin A1c(HbA1c)、serum lipid、urinary albumin excretion rate(UAER) and hemorheology were also measured.40 healthy subjects served as the normal controls.Results　The common abnormality rate of nerve conduction velocity(NCV)was 58.3%,abnormality rate of SNCV、MNCV were 62.9%、56.5%,respectively(p<0.01),and abnomality rate of upper limbs、low limbs were 57.5%、62.7%,respectively. Abnormality rate of NCV increased with prolongation of duration in diabetic patients,NCV was negatively correlated with HbA1c、PBG and UAER,and was no significant correlation with FBG and total cholesterol.Erythrocyte aggregation index(EAI) and low sheer rate of abnormal NCV groups were significantly higher than that of normal NCV groups.Conclusion　 Diabetic peripheral neuropathy was the results of common effect of multiple factors, and should be early prevented and treated.