赵红侠

[摘要] 目的 糖尿病周围神经病变是糖尿病患者常见并发症，严重影响糖尿病患者生活质量。振动感觉阈值能够有效评估2型糖尿病（T2D）患者周围神经病变。糖尿病病程对糖尿病周围神经病变是否有影响，尚不完全明确。该研究主要目的在于分析糖尿病病程对2型糖尿病患者周围神经病变的影响。方法 该研究采用回顾性研究，将年龄匹配的T2D按病程长短分为5组，记录每组患者的一般资料（性别、年龄、病程、糖化血红蛋白、随机血糖和尿肌酐清除率）和振动感觉阈值并进行分析，评估糖尿病病程对患者周围神经病变的影响。结果 随着病程的增加，T2D患者足部振动感觉阈值逐渐增加，病程大于6年后，周围神经病变显著加重。 结论 2型糖尿病患者周围神经病变会随着病程延伸逐渐加重。

[关键词] 周围神经病变；振动感觉阈值；糖尿病；病程

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2017）02（a）-0153-03

[Abstract] Objective Diabetic peripheral neuropathy is a common complication of diabetic patients， which seriously affects the quality of life of diabetic patients. Vibrating perception threshold （VPT） can effectively assess diabetic peripheral neuropathy （DPN） in patients with type 2 diabetic mellitus （T2D）. The influence of diabetes mellitus duration on diabetic peripheral neuropathy is not fully understood. The purpose of this study was to analyze the effect of diabetes mellitus duration on peripheral neuropathy in patients with T2D. Methods Based on the retrospective study， the age matched T2D patients were divided into 5 groups according to duration of disease， general data（sex， age， disease duration， glycosylated hemoglobin， random blood glucose and urine creatinine clearance rate） and vibration perception threshold were recorded and analysed in each group to assess the influence of duration to peripheral neuropathy. Results With the increase of the course of disease， the foot VPT increased gradually in T2D patients， and the DPN deteriorated significantly after 6 years of duration. Conclusion The DPN in patients with type 2 diabetes will gradually deteriorate with the extension of duration.

[Key words] Diabetic peripheral neuropathy （DPN）；Vibrating perception threshold （VPT）；Diabetes mellitus （DM）；Duration

糖尿病周围神经病变（diabetic peripheral neuropathy， DPN）是糖尿病患者常见并发症，可导致足部溃疡、坏疽，严重可致截肢。有效的控制血糖和及时地发现并予以干预，才能有效改善患者预后。已有研究发现，振动感觉阈值（vibrating perception threshold， VPT）与糖尿病神经病变症状的综合评估能够有效诊断2型糖尿病（type 2 diabetes，T2D）患者周围神经病变[1]。糖尿病发病的重要环节是胰岛β细胞功能失代偿，该过程是逐渐进展的，即随着病程的发展，胰岛β细胞进行性功能减退、破坏，胰岛素分泌逐渐降低[2]。然而，目前对于2型糖尿病病程在糖尿病周围神经病变中的作用尚不明确。……