王军文， 温慧军

治疗

硫辛酸对慢性酒精性周围神经病同型半胱氨酸、超敏C反应蛋白及临床症状的作用

王军文， 温慧军

目的观察硫辛酸对慢性酒精性周围神经病(CAPN) 的同型半胱氨酸(HCY)、超敏C反应蛋白(Hs-CRP)及临床症状的作用。方法将46例CAPN 患者随机分为治疗组和对照组，治疗组给予硫辛酸静脉滴注，0.6 g/d；对照组给予甲钴胺注射液避光静脉滴注500 ug/d，连用14 d，比较两组患者治疗前、治疗后HCY及Hs-CRP及变化，并以神经系统症状评分，以评价其疗效。结果治疗后2组患者HCY及Hs-CRP水平明显降低，与治疗前比较，差异有统计学意(P<0.05)，且治疗组Hs-CRP及Hs-CRP水平显著低于对照组，差异有统计学意义(P<0.05)；治疗后两组临床症状评分均降低，与治疗前比较，差异有统计学意义(P<0.05)，且治疗组临床症状评分显著低于对照组，差异有统计学意义(P<0.05)。治疗期间2组患者均未出现明显不良反应。结论硫辛酸可降低CAPN患者HCY及Hs-CRP水平，显著改善患者临床症状，值得应用及研究。

硫辛酸； 慢性酒精性周围神经病； 同型半胱氨酸； 超敏C反应蛋白

Abstract：ObjectiveTo observe the effect of lipoic acid on homocysteine (HCY)，hypersensitive C reactive protein (Hs-CRP) and clinical symptoms of patients with chronic alcoholic peripheral neuropathy (CAPN).Methods46 cases of CAPN patients were randomly divided into treatment group and control group，the treatment group was given intravenous injection of lipoic acid 0.6g/d；the control group was given intravenous infusion of Mecobalamin injection light is 500ug/d. After 14 days treatment，to compare the changes of HCY and Hs-CRP in two groups，to evaluate the scores of nervous system symptoms and efficacy.ResultsAfter treatment，the levels of HCY and Hs-CRP in the two groups were significantly decreased，compared with before treatment，the difference was statistically significant (P<0.05)，the levels of HCY and Hs-CRP in the treatment group were significantly lower than those in the control group，the difference was statistically significant(P<0.05). Compared with before treatment，the clinical symptoms of the two groups were reduced，the difference was statistically significant (P<0.05)，and the treatment group clinical symptom score was significantly lower than the control group，the difference was statistically significant(P<0.05)ConclusionLipoic acid can reduce the level of HCY and Hs-CRP of CAPN patients，significantly improve the clinical symptoms of patients. It is beneficial to the prognosis，is worthy of large-scale application and research.

Keywords： Lipoic acid； Chronic alcoholic peripheral neuropathy； Homocysteine； Hypersensitive C reactive protein

既往基础及临床研究表明，慢性酒精中毒引起的神经系统损害以周围神经发病率最高，而且饮酒量越大、时间越长，周围神经损害越重[1]，酒精引起的神经元死亡与炎症反应及氧化应激反应增加和氧化酶的诱导有关[2]。因此，改善机体氧化应激和炎症因子水平是防治CAPN患者周围神经损害的有效措施之一。国内有研究表明，α-硫辛酸对周围神经病变症状及肢体远端运动有改善作用[3]。有关硫辛酸对CAPN患者HCY、Hs-CRP的临床研究报道很少。本研究探讨硫辛酸对CAPN患者同型半胱氨酸、超敏C反应蛋白及临床症状的作用。

1 资料与方法

1.1 一般资料 选择2015年5月～2017 年3月在本院神经内科就诊的46例CAPN患者，其中男32例，女24例，随机分为治疗组和对照组，每组21例，平均年龄(60.3±3.5)岁。根据Goodwin 等[4]提出的酒精中毒的入选标准：(1)饮酒史，每日饮酒，每次150 g，至少1 y以上，日饮酒量按酒精含量计均超过150 g/d；……