糖调节受损患者周围神经病变的电生理特点及相关因素分析

Characteristics of neuropathy and its influencing factors in patients with IGR

摘要:

目的 研究糖调节受损（IGR）患者周围神经病变电生理特点，分析影响IGR相关神经病变的影响因素。方法 选取2016年8月—2018年8月天津市第四中心医院收治的54例IGR患者作为研究组，另选取同期在该院体检中心体检的50例健康者作为对照组。应用神经电生理检测评价两组研究对象的周围神经功能，包括神经传导检测（正中神经、尺神经、胫神经以及腓总神经/腓肠神经的波幅及传导速度）评价大纤维传导功能，皮肤交感反应（SSR）评价小纤维功能；并收集所有研究对象空腹血糖（FBG）、2?h餐后血糖（2?hPG）、糖化血红蛋白（HbA1c）、胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、血尿酸（UA）、同型半胱氨酸（Hcy）、体重指数（BMI）等相关临床生化指标，采用Logistic回归分析，计算IGR相关神经病变的影响因素。结果 研究组胫神经以及腓肠神经感觉传导速度（SCV）低于对照组（P?<0.05）。研究组下肢SSR波幅小于对照组（P?<0.05）。研究组FBG、2 hPG、HbA1c、TC、LDL-C、BMI、UA及Hcy水平高于对照组（P?<0.05）。影响IGR患者周围神经病变的因素为：TG [OlR=8.529（95% CI：1.634，43.372）]、LDL-C[（OlR=3.273（95% CI：1.202，8.927）]、BMI [OlR=1.385（95% CI：1.122，1.708）、UA [OlR=9.265（95% CI： 1.896，9.437）]及Hcy [OlR=11.336（95% CI：1.928，16.774）]。结论 IGR患者周围神经病变以小纤维及大纤维中的感觉神经髓鞘病变为主，引起IGR患者神经病变的原因可能与BMI、TC、UA、Hcy代谢紊乱引起的代谢综合征有关。

Abstract:

Objective To study the physiological characteristics of peripheral neuropathy of impaired glucose regulation (IGR), and to analyze the influencing factors of neuropathy in IGR patients. Methods Fifty four IGR patients treated from August 2016 to August 2018 in our hospital were selected as research group. 50 healthy check-ups were selected as control group. The peripheral nerve function of the two groups of subjects was evaluated by nerve electrophysiological test. Nerve conduction detections (central nerve, ulnar nerve, tibia nerve, and total peroneal nerve) were used to evaluate large fiber conduction function, and small fiber function was evaluated by skin sympathetic reaction (SSR); the clinical biochemical indexes of fasting blood glucose (FBG), 2 h postprandial plasma glucose (2 hPG), glycosylated hemoglobin (HbA1c), cholesterol (TC) and triacylglycerol (TG) as well as blood uric acid (UA), Homocysteine (Hcy), body mass index (BMI) were observed. The Logistic regression equation was used to analyze its influence factors. Results The SCV of tibial nerve and sural nerve in the study group was lower than that in the control group (P?