腺苷钴胺对糖尿病周围神经病变患者血清同型半胱氨酸水平的影响研究

目的：探讨腺苷钴胺对2型糖尿病周围神经病变（DPN）患者血清同型半胱氨酸（Hcy）水平的影响。方法：选择2014年1月～2015年3月期间我院内分泌科收治的74例糖尿病周围神经病变患者，根据随机数字表法将其随机分为两组，对照组予控制血糖等常规治疗，观察组联合应用腺苷钴胺注射液肌肉注射，治疗前后采用症状总评分法（TSS）对患者的神经症状进行评分，比较两组患者临床症状及血浆Hcy水平，并对患者的双侧胫总神经、腓总神经的运动神经传导速度（MNCV）、感觉神经传导速度（SNCV）进行测定。结果：对照组患者治疗后血浆Hcy水平、TSS评分及胫神经、腓神经MNCV、SNCV与治疗前比较差异无统计学意义；观察组患者治疗后TSS评分中疼痛、感觉异常、灼热感、麻木及总评分均较治疗前明显降低；并且观察组患者血浆Hcy水平以及胫神经、腓神经MNCV、SNCV明显增快；观察组患者治疗总有效率为86.48%，明显高于对照组的64.86%；观察组有2例患者出现胃纳减退，不良反应发生率为5.41%。结论：腺苷钴胺治疗DPN可以明显降低血浆Hcy水平，改善神经传导速度及临床症状，提高临床疗效。

Effect of adenosine cobalt on serum homocysteine level in patients with diabetic peripheral neuropathy

Objective To investigate the effect of adenosine cobalt on serum homocysteine (Hcy) level in patients with diabetic peripheral neuropathy(DPN). Methods 74 patients with diabetic peripheral neuropathy treated in our hospital dur-ing the period from January 2014 to March 2015 were randomly divided into two groups according to the random number table method, the control group was treated with conventional therapy,the observation group was treated with adenosine cobalt (1 mg, im, qd). Before and after treatment,Total Symptom Score (TSS) was performed on neurological symptoms ,the clinical symptoms and plasma Hcy level were compared between the two groups,the motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) were measured in the bilateral tibial nerve and common nerve. Results There were of no signifi-cant difference in plasma Hcy level, TSS score ,the tibial nerve, peroneal nerve MNCV and SNCV in the control group. The TSS scores of pain, paresthesia, burning sensation, numbness and total scores in observation group were significantly lower than be-fore treatment, the differences were of statistically significant;while the level of Hcy in the observation group were significantly lower than before treatment, the tibial nerve, peroneal nerve MNCV and SNCV was increased faster, and the difference was of statistically significant. The total effective rate in the observation group was 86.48%, and it was significantly higher than that of the control group which was 64.86%, the difference was of statistically significant. In the in observation group, there were 2 cases of patients with gastric and the adverse reaction rate was 5.41%. Conclusion The treatment of adenosine cobalt can sig-nificantly reduce plasma homocysteine level and improve nerve conduction velocity and clinical symptoms in patients with DPN, and improve the clinical efficacy.