2型糖尿病并发痛性糖尿病神经病变的影响因素研究

背景　痛性糖尿病神经病变（PDN）是糖尿病常见的并发症之一，但常被忽略或误诊，如果对糖尿病并发疼痛的危险因素缺乏认知，则易造成延误治疗。目的　探究2型糖尿病（T2DM）并发PDN的影响因素，为临床早期干预、积极预防提供对策。方法　选取2016年1月-2019年12月于安庆市立医院内分泌科住院的符合研究标准的T2DM患者273例，根据其有无PDN分为单纯糖尿病组（NPDN组，n=185）及T2DM并发PDN组（PDN组，n=88）。比较两组患者一般资料及实验室检查指标，采用多因素非条件Logistic回归分析探究T2DM并发PDN的影响因素。结果　PDN组患者年龄大于NPDN组，T2DM病程长于NPDN组，体质指数（BMI）、糖尿病视网膜病变（DR）发生率、糖尿病肾病（DKD）发生率、空腹血糖（FPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）高于NPDN组，餐后1 hC肽（1 hCP）、餐后2 hC肽（2 hCP）低于NPDN组（P<0.05）。多因素非条件Logistic回归分析结果显示，T2DM病程〔OR=1.079，95%CI（1.003，1.160）〕、DR〔OR=7.524，95%CI（1.363，41.541）〕、DKD〔OR=3.547，95%CI（1.134，11.095）〕、FPG〔OR=1.831，95%CI（1.384，2.422）〕、HbA1c〔OR=2.468，95%CI（1.694，3.596）〕是T2DM并发PDN的影响因素（P<0.05）。结论　T2DM病程、DR、DKD、FPG、HbA1c是T2DM并发PDN的影响因素，临床应注意积极预防、早期干预存在上述影响因素的T2DM患者。

Influencing Factors of Painful Diabetic Neuropathy in Type 2 Diabetes Mellitus

Background　As a common complication of type 2 diabetes mellitus （T2DM），painful diabetic neuropathy（PDN） is often overlooked or misdiagnosed，particularly in physicians with lack of sufficient understanding of related risk factors，which may delay appropriate treatment.Objective　To explore the influencing factors of PDN in T2DM，providing countermeasures for early clinical intervention and active prevention of this disease.Methods　273 eligible T2DM patients who were hospitalized in Department of Endocrinology，Anqing Municipal Hospital were enrolled from January 2016 to December 2019，including 88 with PDN（PDN group），and 185 without（NPDN group）.The demographic information and laboratory test results were compared between the two groups.Multivariate unconditional Logistic regression analysis was used to explore the influencing factors of PDN.Results　PDN group showed greater average age，BMI，FPG，2 hPG，HbA1c，and longer average course of T2DM，higher prevalence of diabetic retinopathy and diabetic kidney disease，as well as lower average 1-hour and 2-hour postprandial C-peptide levels（P<0.05）.Multivariate unconditional Logistic regression analysis showed that the course of T2DM 〔OR=1.079，95%CI（1.003，1.160）〕，diabetic retinopathy〔OR=7.524，95%CI（1.363，41.541）〕，diabetic kidney disease〔OR=3.547，95%CI（1.134，11.095）〕，FPG 〔OR=1.831，95%CI（1.384，2.422）〕，and HbA1c〔OR=2.468，95%CI（1.694，3.596）〕were associated with PDN in T2DM （P<0.05）.Conclusion　The course of T2DM，diabetic retinopathy，diabetic kidney disease，FPG and HbA1c may be influencing factors of PDN in T2DM.Clinical attention should be paid to these factors in T2DM patients to early prevent PDN or deliver interventions.