前列地尔注射液联合甲钴铵注射液治疗糖尿病外周神经病变的临床疗效及对血浆同型半胱氨酸的影响

目的 探讨前列地尔注射液联合甲钴铵注射液治疗糖尿病外周神经病变（DPN）的临床疗效及对血浆同型半胱氨酸（Hcy）的影响.方法 80例DPN患者,随机分为两组.治疗组采用前列地尔注射液静脉滴注联合甲钴铵注射液肌注,1次/d,连用2周;对照组采用红花黄色素静脉滴注,1次/d,连用2周.比较治疗前后血脂血糖、血浆胰岛素、超敏C反应蛋白（Hs-CRP）、Hcy和临床症状及下肢神经传导速度改善情况,并分析血浆Hcy与各指标间的相关性.结果 前列地尔注射液联合甲钴铵注射液治疗DPN取得了92.86%的临床疗效,且可增加神经传导速度.前列地尔注射液联合甲钴铵注射液治疗治疗2周后空腹血糖（FBG）、胰岛素（Fins）、超敏-C反应蛋白（Hs-CRP）和Hcy明显降低.DPN患者Hcy与病程、FBG和Hs-CRP呈正相关,与MCV正中神经和SCV腓总神经呈负相关（P〈0.01或P 〈0.05）,FBG、SCV腓总神经和Hs-CRP为影响DPN患者Hcy的独立相关因素.结论 前列地尔注射液联合甲钴铵注射液治疗可明显改善DPN患者临床症状及增加神经传导速度,同时降低血浆Hcy水平.

Effects of combined alprostadil injection and mecobalamin on diabetic peripheral neuropathy and plasma homocysteine level.

Objective To investigate the effects of combined alprostadil injection and mecobalamin on diabetic peripheral neuropathy （DPN） and plasma homecysteine （Hey） level. Methods Eighty DPN patients were randomly divided into 2 groups. The treatment group re- eeived intravenous infusion of alprestadil and intramuscular mecobalamin once a day for 2 continuous weeks, while the control group received intra- venous infusion of safflower yellow once a day for 2 continuous weeks. The improvement of clinical symptoms and nerve conduction velocity before and after treatment was observed. Blood glucose, lipid, fasting plasma insulin （ Fins）, high - sensitivity C - reactive protein （ hs - CRP） and Hcy were measured before and after treatment and relationship between plasma Hcy level and each index was analyzed. Results Total effective rate of combined alprestadil injection and mecobalamin in the treatment of DPN was 92.86%. Combined alprostadil injection and mecobalamin also in- creased nerve conduction velocity. FBG, Fins, Hs - CRP and Hcy were significantly decreased in DPN patients after 2 weeks treatment of com- bined alprestadil injection and mecobalamin. Plasma Hcy level in DPN group was positively related to the course of disease, FBG and Hs -CRP, and negatively with MCV and SCV （ P 〈0.01 orP 〈0.05）. Multiple regression analysis showed that FBG, SCV and Hs -CRP were the inde- pendent risk factors of plasma Hcy in patients with DPN. Conclusion Combined alprostadil injection and mecobalamin can significantly improve clinical symptoms, increase nerve conduction velocity and decreased plasma Hcy levels.