2型糖尿病患者振动觉阈值检测及影响因素

目的 探讨振动觉阈值检测对2型糖尿病患者下肢神经病变的诊断意义及其影响因素.方法 测定2008年8月至2009年4月在我院内分泌代谢科门诊就诊的1018例2型糖尿病患者振动觉阈值,根据振动觉阈值风险度将其分为低风险组(<15 V)484例、中风险组(15～25 V)302例、高风险组(>25 V)232例.比较患者下肢神经病变症状、基本情况和血糖控制指标,分析其影响因素.采用卡方检验、t检验、单因素方差分析等进行统计学分析.结果 低风险组、中风险组、高风险组分别占47.54%、29.67%、22.79%,中风险组、高风险组有神经病变症状者所占比例明显高于低风险组(分别为61.26%、65.52%、39.26%).各组年龄、糖尿病病程、收缩压、糖化血红蛋白及糖化血清蛋白差异有统计学意义(均P<0.05),男性振动觉阈值明显高于女性(P<0.01).振动觉阈值与年龄、性别、糖尿病病程、收缩压、糖化血红蛋白、糖化血清蛋白、空腹血糖呈正相关(P<0.05).多元回归分析显示年龄(P=0.000)、糖化血红蛋白(P=0.046)及糖化血清蛋白(P=0.030)是振动觉阈值的独立影响因素.结论 采用振动觉阈值检测筛查门诊2型糖尿病患者糖尿病周围神经病变的患病率为22.79%,年龄、糖化血红蛋白、糖化血清蛋白是振动觉阈值的独立影响因素.

Vibration perception threshold of type 2 diabetic patients and its influencing factors

Objective To investigate the morbidity rate of diabetic peripheral neuropathy (DPN) and analyze its related factors through the testing of the vibration perception threshold (VPT) in outpatients with type 2 diabetes meUitus (T2DM). Methods VPT on both feet in 1018 T2DM outpatients was examined by the quantitative examination equipment of vibration perception. The participants were then assigned to the low-risk group (<15 V, n=484), mediate-risk group (15 to 25 V, n=302), and high-risk group (> 25 V, n=232). The clinical characteristics and biochemical parameters were compared. Results The patients in the low-risk, mediate-risk, and high-risk group accounted for 47.54%, 29.67%, and 22.79%, respectively. The patients with neuropathy symptoms accounted for 39.26%, 61.26%, and 65.52% in the low-risk, mediate-risk, and high-risk group, respectively. There were significant differences in age, diabetic duration, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) and glycated serum albumin (GA) among the three groups (all P < 0.05). VPF of male patients was worse than that of female patients (P < 0.01). VPT was positively correlated with age, gender, diabetic duration, SBP, HbA1c, GA, and fasting plasma glucose (FPG) (all P <0.05). In multiple stepwise regression analysis, age (P=0.000), HbA1c (P=0.046), and GA (P=0.030) were independent influencing factors of VPT. Conclusions The prevalence of DPN was 22.79% screened by VFF examination in type 2 diabetic outpatients. Age, HbA1c and GA may be independent influencing factors of VPT.