三磷酸胞苷对糖尿病周围神经病变患者神经传导速度的影响

背景三磷酸胞苷(cytridinitriphosphatis,CTP)主要用于脑血管意外及其后遗症,脑震荡,脑血管硬化,老年性痴呆等的治疗,而该药对糖尿病周围神经病变的作用又如何呢?目的观察CTP改善糖尿病周围神经病变患者神经功能作用,并评价该药作用效果及神经电生理作用.设计以患者为研究对象,前瞻性随机对照设计的验证性实验研究.单位第四军医大学医院内分泌科病房.对象1999-09/2000-02在第四军医大学西京医院内分泌科住院的糖尿病周围神经病变患者50例,符合纳入标准糖尿病周围神经病变患者50例,男28例,女22例.将50例患者随机分为治疗组和对照组各25例,均知情同意.方法治疗组25例用CTP60mg加入生理盐水100mL维生素D,1次/d.对照组25例用维生素B1100 mg和维生素B12 500 μg,1次/d,东莨菪碱(654-2)20 mg加入生理盐水100 mL维生素D,1次/d,疗程均为14d.神经传导速度采用的是表面电极顺行性测定.主要观察指标两组患者肢体神经传导速度.结果治疗组患者经过CTP治疗14d后,双上肢及下肢正中神经、尺神经、腓总神经、胫神经传导速度明显高于对照组(P<0.05～0.01).治疗组患者经过三磷酸胞苷14d治疗后,神经症状、神经体征评分(1.4±0.5,3.0±0.5)明显低于对照组(2.6±0.3,4.0±03)(t=3.255,2.005,P<0 05).结论三磷酸胞苷能有效改善糖尿病周围神经病变患者的神经传导速度.

Effect of cytridine triphosphate on nerve conduction velocity in patients with diabetic peripheral neuropathy

BACKGROUND: Cytridinie triphosphate(CTP) is predominantly used for cerebrovascualr accident and its sequelae, brain concussion, cerebral arteriosclerosis, senile dementia. What about its effect on diabetic peripheral neuropathies?OBJECTIVE: To observe the efficacy of cytridine triphosphate in improving nerve function and nerve conduction velocity in diabetic peripheral neuropathy.DESIGN: A prospective and randomized and controlled trial based on the patients.SETTING: Endocrine department of a military medical university.SUBJECTS: Totally 50 patients with diabetic peripheral neuropathy, hospitalized in Endocrine Department of Xijing Hospital of Fourth Military Medical University, were enrolled in this study from September 1999 to February 2000. All the patients were according to the including criteria, including 28 male and 22 female patients. They were randomly divided into treatment and control group averagely. Informed consent was obtained from all patients.METHODS: The 25 patients in treatment group received daily intravenous injection of 60 mg CTP. The other 25 in the control group received 100 mg vitamin B1 and 500 μg vitamin B12 and 20 mg scopolamine(654-2) and 100 mL saline as well every day. The treatment lasted for 14 days. The nerve conduction velocity was orthodromicly measured by surface electrode.MAIN OUTCOME MEASURES: Nerve conduction velocity in both groups.RESULTS: After treatment, the nerve conduction velocities of median nerve,ulnar nerve, fibular nerve, tibial nerve in the treatment group were higher than those in the control group (P < 0.05- 0. 01 ) . The neurological symptom and sign score in the treatment group(1. 4 ± 0.5, 3.0 ± 0.5) was less than that in the control group(2.6±0.3, 4.0±0.3) (t=3.255,2.005, P <0.05).CONCLUSION: CTP is effective in improving nerve conduction velocity in diabetic peripheral neuropathy.