2型糖尿病周围神经病变患者甲襞微循环变化特点

目的探讨2型糖尿病(T2DM)周围神经病变(DPN)患者甲襞微循环的变化特点。方法住院T2DM患者600例,根据肌电图结果分为DPN组488例和无DPN(NDPN)组112例,另选择30例正常人作为健康对照组,检查3组的甲襞微循环形态、流态、血管周围状态等指标,并进行比较。结果 (1)微循环特征:与健康对照组比较,DPN组和NDPN组甲襞微循环形态和袢周积分明显升高(P<0.01);与NDPN组比较,DPN组袢周积分和总积分升高(P<0.01)。(2)甲襞微循环表现:与健康对照组比较,2组患者袢周渗出、出血积分升高,DPN组管袢数、乳头积分升高,袢顶直径减小(P<0.05,P<0.01),且DPN组袢顶直径和乳头积分与NDPN组比较差异亦有统计学意义(P<0.05)。(3)病变程度:2组患者甲襞微循环正常者比例明显低于健康对照组(P<0.01),DPN组中度异常的比例高于NDPN组(52.9%vs 19.6%,P<0.01),正常者和轻度异常者比例低于NDPN组(分别为13.5%vs 31.2%,25.0%vs 43.8%,P<0.01)。结论 T2DM患者均存在甲襞微循环异常,DPN患者甲襞微循环异常更为严重,可能是DPN的病因之一。

The characteristics of nailfold microcirculation in patients with type 2 diabetes peripheral neuropathy

Objective To discuss the characteristics of nailfold microcirculation in type 2 diabetes mellitus（T2DM） patients with peripheral neuropathy（DPN）.Methods Examed indicators of 600 cases of hospitalized patients with T2DM, including the nailfold microcirculation shape,flow pattern,state of blood vessels around,etc.Another 30 cases of normal people as control group;compare the nailfold microcirculation status of three groups.Results（1） DPN group in the form,periloop and total score were higher than that in the control group（P〈0.01）,in the course of the disease,age,peri-loop and total score greater than NDPN group（P〈0.01）;loop number,nipple score was significantly higher than the control group （P〈0.05 or P〈0.01） and NDPN group（P〈0.05）,the loop top diameter smaller than that of the control group（P〈0.01） and NDPN group（P〈0.05）;exudation and bleeding score in DPN group and NDPN group were higher than those of the control group（P〈0.01 or P〈0.05）.（2） The abnormalities of moderate and severe were not detected in the control group.The normal proportion in DPN group and NDPN group lower than that in the control group,the DPN group moderately abnormal proportion was higher than that of NDPN group（52.9%vs.19.6%,P〈0.01 ）,normal and mild abnormal was lower than of NDPN group（respectively 13.5%vs.31.2%,25.0%vs.43.8%,P〈0.01）.Conclusion There have abnormal nailfold microcirculation in T2DM patients,the DPN those nailfold microcirculation abnormalities is more serious,may be one of the causes of DPN.