糖尿病颅神经病变的临床特征及对预后的影响

目的 观察糖尿病颅神经病变（DCN）患者的临床资料特征，并分析DCN的危险因素及预后的影响因素。方法 回顾性分析36例DCN患者和40例单纯糖尿病患者的临床资料。分析糖尿病患者合并DCN的危险因素和影响DCN预后的危险因素。结果 ①DCN组糖尿病病程、空腹血糖（FPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）及吸烟、合并糖尿病视网膜病变（DR）患者比例均高于糖尿病组（P＜0.01）。②DCN组收缩期峰值血流速度（Vs）、平均血流速度（Vm）、搏动指数（PI）及阻力指数（RI）均高于糖尿病组（P＜0.01）。③Logistic回归分析显示，FPG、2 hPG、HbA1c及合并DR是糖尿病合并DCN的危险因素；糖尿病病程、HbA1c及合并高血压是DCN预后的影响因素。结论 积极控制血糖是预防糖尿病患者合并DCN发生及改善DCN患者预后的关键所在；糖尿病病程长、HbA1c高及合并高血压可能与DCN患者的预后有关。

Clinical features of patients with diabetic cranial neuropathy and effect on prognosis

Objective To observe the clinical features of patients with diabetic cranial neuropathy (DCN), and analyze the risk factors for DCN and the influence factors for prognosis. Methods The clinical features of 36 patients with DCN (DCN group) and 40 diabetic patients (DM group) were analyzed and compared. Multifactor logistic regression was used to analyze the risk factors of diabetic patients with DCN and the risk factors affecting the prognosis of DCN. Results ①The DM course, FPG, 2 hPG, HbA1c and the ratio of smoking and DR were significantly higher in DCN group than those in DM group (P＜0.01). ②The levels of Vs, Vm, PI and RI were significantly higher in DCN group than those in DM group (P＜0.01). ③Logistic regression analysis showed that FPG, 2 hPG, HbA1c and with DR were risk factors for diabetic patients with DCN; DM course, HbA1c and with hypertension were influence factors for prognosis of DCN patients. Conclusion Positive control of blood sugar is the key to prevent the diabetic patients with DCN; the prognosis of DCN patients may be related to long DM course, higher HbA1c and hypertension.