高同型半胱氨酸血症对2型 糖尿病交感神经功能状态的影响

摘要 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例并与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、波幅及同侧上下肢SSR相对比值差异。结果：Hhcy组和非Hhcy组SSR潜伏期上肢分别为（1593.11±149.85) ms、（1539.75±149.22 )ms（P>0.05）；下肢分别为（2795.86±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)mV、（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组同侧上下肢SSR波幅相对比值Hhcy组比非Hhcy组增高（P＜0.001），而同侧上下肢SSR潜伏期相对比值2组差异无统计学意义。结论：Hhcy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。

Affection of hyperhomocysteinemia on sympathetic nervous fanction of 2 type diabetic mmellitus

Affection of hyperhomocysteinemia on sympathetic nervous function of 2 type diabetic mellitus WANG suhong, ZHANG zhecheng, LIU na, ZHU ju, ZHANG jing Department of Neurology, The Third Central Clinical College of Tianjin Medical University, Tianjin 300170,China Abstrict Object:To investigate affection of hyperhomocysteinemia（Hhcy）on sympathetic nervous function of 2 type diabetic mellitus（DM）by detection of sympathetic skin reflex（SSR）.Methods:44 patients with 2 type DM were divided two groups: Hhcy group(n=22) and NHhcy group(n=22).Detection of SSR were given to four limbs of all patients, record and compare average latencies、amplitudes and ratios of upper to lower limbs. Results: SSR upper limbs latencies in Hhcy group (1593.11±149.85)ms] were prolonged than that in NHhcy (1539.75±149.22)ms](p>0.05).SSR lower limbs latencies in Hhcy group (2795.86±415.24)ms] were prolonged than that in NHhcy group (2617.93±327.61)ms](p＜0.05). SSR upper limbs amplitudes in Hhcy group (1.03±0.38)mv] were reduced than that in NHhcy group (1.22±0.30mv) (p＜0.01).SSR lower limbs amplitudes in Hhcy group (0.28±0.17)mv]were reduced than that in NHhcy group （0.38±0.15)mv](p＜0.01). Amplitude ratios of upper to lower limbs in Hhcy group were higher than that in NHhcy group, z=3.5176, p＜0.001;but latency ratios of upper to lower limbs between 2 groups had not statistical significance。Conclusion：Hhcy may increase the damage to sympathetic nervous of 2 type DM; it has features of Length dependence, and detection of SSR provides Simple and feasible technique.