糖尿病神经病变与微循环的关系

为研究糖尿病神经病变与微循环的关系，对１１７例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）并发糖尿病周围神经病变（ＤＰＮ）患者甲襞微循环进行了观察，并与无ＤＰＮ组（３６例）进行比较。结果显示，ＤＰＮ患者有明显的微循环障碍，ＤＰＮ组微血管形态、流态和袢周状态均有显著异常。与无ＤＰＮ组比较，ＤＰＮ患者血液流速明显减慢（Ｐ＜０．０５），并有明显的血细胞聚集（Ｐ＜０．０５）、袢周渗出（Ｐ＜０．０１）与出血（Ｐ＜０．０５）。Ｌｏｇｉｓｔｉｃ逐步回归分析显示，微循环障碍是糖尿病神经病变发病的独立危险因素（ＯＲ：１．５７；９５％ＣＩ：１．１８２．０９）。

Relation between Diabetic Neuropathy and Microcirculation

In order to study the relation between diabetic neuropathy and microcirculation, the nailfold microcirculation in 117 cases with non insulin dependent diabetes mellitus(NIDDM) complicated with diabetic peripheral neuropathy(DPN) were observed, compared with the group(36 cases) without DPN. It was found that there were more evident disturbances in microcirculation in patients with DPN, abnormalities of morphology of microvessels, the form of blood flow and the state around the loop in the group with DPN were all more significant. There were markedly slowed velocity of blood flow(P<0.05), increased aggregation of blood cells(P<0.05), obvious exudation(P<0.01) and hemorrhage(P<0.05) around the loop in the group with DPN, compared with the group without DPN. The analyse of Logistic multiple regression indicated that the changes of the microcirculation was the independent risk factor for diabetic neuropathy(OR: 1.57; 95% CI: 1.18～2.09).