糖尿病足患者腓神经传导速度及相关因素分析

目的 分析糖尿病足溃疡患者和未发生糖尿病足的2型糖尿病患者的肌电图腓神经传导速度的差异及其影响因素.方法 收集54例住院糖尿病足患者和54例住院不伴有糖尿病足的2型糖尿病患者的资料,回顾性分析这108例患者的临床资料,研究糖尿病足溃疡患者和未发生糖尿病足的2型糖尿病患者的肌电图腓神经传导速度的差异及其影响因素.结果 糖尿病足组与对照组相比,双下肢肌电图腓神经传导速度较慢,差异有统计学意义(P<0.05).两组患者在受教育程度、白细胞计数、中性粒细胞比例、血红蛋白、白蛋白、踝肱指数(ABI)方面差异有统计学意义(P<0.05).腓神经感觉神经传导速度与糖化血红蛋白、白细胞计数、中性粒细胞比例呈负相关性(P<0.05);与空腹C肽水平、血红蛋白、白蛋白及ABI呈正相关性(P<0.05).腓神经运动神经传导速度与吸烟时间、糖化血红蛋白、中性粒细胞比例呈负相关性(P<0.05);与血红蛋白、白蛋白水平呈正相关性(P<0.05). 结论 糖尿病周围神经病变是导致糖尿病足溃疡的重要危险因素.血糖控制差、感染、吸烟、胰岛功能差、贫血、低蛋白血症及下肢血供差均可能是糖尿病周围神经病变发生或发展的促进因素.因此,预防和治疗糖尿病足就应该注重血糖控制、积极抗感染、改善或保护患者胰岛功能、纠正贫血和低蛋白血症,同时需注重对患者进行糖尿病教育及足病知识教育.

neuropathy[J].Diabetes Res Clin Pract, 2002, 57(2): 111-7.Analysis of peroneal nerve conduction velocity andits correlation factors in patients with diabetic foot

Objective To investigate the difference in EMG peroneal nerve conduction velocity between patients with diabetic foot ulcers and T2DM patients without diabetic foot and its influencing factors.Methods Retrospective analysis was performed on clinical data of a total of 108 patients, including 54 inpatients with diabetic foot and 54 T2DM patients without diabetic foot ulcers, so as to investigate the difference in EMG peroneal nerve conduction velocity between these two groups of patients and its influencing factors.Results Compared with the control group, EMG peroneal nerve conduction velocity was slower in the diabetic foot group, with statistically significant difference (P<0.05).There were significant differences in education attainment, WBC count, neutrophil ratio, hemoglobin, albumin, and ABI between the two groups (P<0.05).Peroneal sensory nerve conduction velocity presented negative correlation with HbA1C, WBC count, and neutrophil ratio(P<0.05), and positive correlation with fasting C-peptide level, hemoglobin, albumin, and ABI (P<0.05).Peroneal motor nerve conduction velocity presented negative correlation with smoking duration, HbA1C, and neutrophil ratio (P<0.05), and positive correlation with hemoglobin and albumin (P<0.05).Conclusion Diabetic perineuropathy is an important risk factor for diabetic foot ulcers.Poor blood glucose control, infection, smoking, poor pancreatic islet function, anemia, hypoproteinemia, and poor lower limb blood supply may contribute to the development or progression of diabetic perineuropathy.In preventing and treating diabetic foot, it is therefore desirable to lay stress on blood glucose control, give active anti-infective treatment, improve or protect pancreatic islet function, and correct anemia and hypoproteinemia;attention should also be paid to patient education on diabetes and foot diseases.