2型糖尿病患者血清神经元特异性烯醇化酶水平与糖尿病周围神经病变的关系
发布时间：2018-08-12 08:46
【摘要】：目的观察2型糖尿病患者血清神经元特异性烯醇化酶(Neuron specific enolase,NSE)水平,探讨其与糖尿病周围神经病变(Diabetic peripheral neuropathy,DPN)的相关性,为DPN的防治提供理论依据。方法依据1999年WHO糖尿病诊断及分型标准选取2013.1-2014.8华北理工大学附属医院内分泌科住院的2型糖尿病患者106例,其中男57例,女49例,年龄28-80岁,平均(54.50±10.63)岁。根据DPN诊断标准将糖尿病患者分为两组,单纯糖尿病组(DM组)56例,其中男30例,女26例,年龄28-80岁,平均(53.73±9.76)岁;糖尿病周围神经病变组(DPN组)50例,其中男27例,女23例,年龄31-79岁,平均(55.36±11.57)岁。又根据TCSS评分将DPN组分为轻度DPN组;中度DPN组;重度DPN组;所有研究对象均测量周围神经传导速度、身高、体重、血压。所有研究对象空腹12h以上,晨起抽取静脉血检测血清甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、总胆固醇(TC)、糖化血红蛋白(Hb A1c)、空腹血糖(FPG)、血清神经元特异性烯醇化酶(NSE)水平。所有数据分析应用IBM SPSS19.0统计软件包进行统计分析,计量资料以均数±标准差(x±s)表示,两组数据之间用t检验进行比较;组间率的比较采用χ2检验;多组数据间比较采用单因素方差分析。指标间相关性采用Pearson相关分析,并计算相关系数。采用多因素非条件Logistic回归分析进行DPN危险因素的分析。P0.05为差异有统计学意义。结果1 DPN组与DM组比较性别构成经χ2检验差异无统计学意义(P0.05),说明本次研究对象的性别构成具有可比性。DPN组与DM组年龄比较差异无统计学意义(P0.05)。2 DPN组与DM组病程比较,DPN组高于DM组差异有统计学意义(P0.05)。3 DPN组BMI、SBP、DBP、LDL-C、FPG、Hb A1c、TC、TG水平高于DM组,差异有统计学意义(P0.05)。4 DPN组HDL-C水平低于DM组,差异有统计学意义(P0.05)。5血清NSE水平DPN组高于DM组,随着DPN程度的加重升高明显,差异有统计学意义(P0.05)。6 DM组12例血清NSE大于13ug/L,DPN组27例患者血清NSE大于13ug/L,经χ2检验OR=4.3,说明血清NSE高于正常范围时,糖尿病患者发生DPN的危险性增加3.3倍。7 DPN组与DM组NCV比较,尺神经、正中神经、腓总神经、胫神经MCV以及尺神经、正中神经、腓肠神经SCV显著减慢,差异有统计学意义(P0.05)。8将糖尿病患者以血清NSE水平由低到高按四分位间距分组,随着血清NSE水平升高神经传导速度显著减慢,组间比较差异有统计学意义(P0.05)。9以是否合并DPN为因变量,以各临床指标为自变量,行多因素非条件Logistic回归分析结果显示,DPN与病程、TG、LDL-C、BMI、SBP、DBP、Hb A1c、血清NSE呈正相关(P0.05)。10进行Pearson相关分析显示NSE水平与LDL-C、TG、Hb A1c、病程、FPG呈正相关(r分别为0.654,0.899,0.599,0.852,0.535,P0.05)。与年龄、性别无相关(P0.05)。结论1糖尿病周围神经病变患者血清NSE水平高于单纯糖尿病患者,并且随着DPN程度的加重升高明显。2神经传导速度下降,血清NSE水平升高。3血清NSE和病程、LDL-C、TG、Hb A1c、FPG呈正相关。
[Abstract]:Objective To observe the level of serum neuron specific enolase (NSE) in patients with type 2 diabetes mellitus (T2DM), and to explore the correlation between NSE and diabetic peripheral neuropathy (DPN), so as to provide theoretical basis for the prevention and treatment of DPN. 106 patients with type 2 diabetes mellitus were hospitalized in the Department of Endocrinology, Affiliated Hospital of North Polytechnic University, including 57 males and 49 females, aged 28-80 years, with an average age of (54.50 (+ 10.63) years. According to the DPN diagnostic criteria, 56 patients with diabetes mellitus were divided into two groups, simple diabetes group (DM group), including 30 males and 26 females, aged 28-80 years, with an average age of (53.73 (+ 9.76) years. Neuropathy group (DPN group) consisted of 50 cases, including 27 males and 23 females, aged 31-79 years, with an average age of (55.36 + 11.57). DPN was divided into mild DPN group, moderate DPN group, severe DPN group, and peripheral nerve conduction velocity, height, weight and blood pressure were measured in all subjects. Serum triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), total cholesterol (TC), glycosylated hemoglobin (Hb A1c), fasting blood glucose (FPG), and serum neuron-specific enolase (NSE) levels were analyzed by IBM SPSS 19.0 statistical software package. The measurements were expressed as mean (+) standard deviation (x + s). Pearson correlation analysis was used to calculate the correlation coefficient. Multivariate unconditional logistic regression analysis was used to analyze the risk factors of DPN. The difference was statistically significant (P 0.05). Results There was no significant difference in sex composition between DPN group and DM group (P 0.05). There was no significant difference in age between DPN group and DM group (P 0.05). Compared with DM group, BMI, SBP, DBP, LDL-LDL in DPN group were significantly higher than those in DM group (P 0.05). The serum levels of C, FPG, Hb A1c, TC and TG in DPN group were significantly higher than those in DM group (P 0.05). 4 The serum levels of HDL-C in DPN group were lower than those in DM group (P 0.05). 5 The serum levels of NSE in DPN group were higher than those in DM group (P 0.05). The serum levels of NSE in 12 DM group were higher than that in 13 ug/L, and the serum levels of NSE in 27 DPN group were higher than those in DM group (P 0.05). At 13ug/L, OR = 4.3 by_2 test showed that when serum NSE was higher than normal range, the risk of DPN in diabetic patients increased 3.3 times. 7 DPN group compared with DM group NCV, ulnar nerve, median nerve, common peroneal nerve, tibial nerve MCV and ulnar nerve, median nerve, sural nerve SCV significantly slowed down, the difference was statistically significant (P 0.05). The nerve conduction velocity decreased significantly with the increase of serum NSE level (P 0.05). 9 With DPN as a dependent variable and clinical indicators as an independent variable, multivariate non-conditional logistic regression analysis showed that DPN and course of disease, TG, LDL-C, BMI. Pearson correlation analysis showed that NSE level was positively correlated with LDL-C, TG, Hb A1c, course of disease and FPG (r were 0.654, 0.899, 0.599, 0.852, 0.535, P 0.05 respectively). There was no correlation between NSE level and age, sex (P 0.05). Conclusion 1 The serum NSE level in patients with diabetic peripheral neuropathy was higher than that in patients with diabetes mellitus alone. With the aggravation of DPN, nerve conduction velocity decreased, serum NSE level increased. 3 Serum NSE and course of disease, LDL-C, TG, Hb A1c, FPG were positively correlated.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2
本文编号：2178544
[Abstract]:Objective To observe the level of serum neuron specific enolase (NSE) in patients with type 2 diabetes mellitus (T2DM), and to explore the correlation between NSE and diabetic peripheral neuropathy (DPN), so as to provide theoretical basis for the prevention and treatment of DPN. 106 patients with type 2 diabetes mellitus were hospitalized in the Department of Endocrinology, Affiliated Hospital of North Polytechnic University, including 57 males and 49 females, aged 28-80 years, with an average age of (54.50 (+ 10.63) years. According to the DPN diagnostic criteria, 56 patients with diabetes mellitus were divided into two groups, simple diabetes group (DM group), including 30 males and 26 females, aged 28-80 years, with an average age of (53.73 (+ 9.76) years. Neuropathy group (DPN group) consisted of 50 cases, including 27 males and 23 females, aged 31-79 years, with an average age of (55.36 + 11.57). DPN was divided into mild DPN group, moderate DPN group, severe DPN group, and peripheral nerve conduction velocity, height, weight and blood pressure were measured in all subjects. Serum triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), total cholesterol (TC), glycosylated hemoglobin (Hb A1c), fasting blood glucose (FPG), and serum neuron-specific enolase (NSE) levels were analyzed by IBM SPSS 19.0 statistical software package. The measurements were expressed as mean (+) standard deviation (x + s). Pearson correlation analysis was used to calculate the correlation coefficient. Multivariate unconditional logistic regression analysis was used to analyze the risk factors of DPN. The difference was statistically significant (P 0.05). Results There was no significant difference in sex composition between DPN group and DM group (P 0.05). There was no significant difference in age between DPN group and DM group (P 0.05). Compared with DM group, BMI, SBP, DBP, LDL-LDL in DPN group were significantly higher than those in DM group (P 0.05). The serum levels of C, FPG, Hb A1c, TC and TG in DPN group were significantly higher than those in DM group (P 0.05). 4 The serum levels of HDL-C in DPN group were lower than those in DM group (P 0.05). 5 The serum levels of NSE in DPN group were higher than those in DM group (P 0.05). The serum levels of NSE in 12 DM group were higher than that in 13 ug/L, and the serum levels of NSE in 27 DPN group were higher than those in DM group (P 0.05). At 13ug/L, OR = 4.3 by_2 test showed that when serum NSE was higher than normal range, the risk of DPN in diabetic patients increased 3.3 times. 7 DPN group compared with DM group NCV, ulnar nerve, median nerve, common peroneal nerve, tibial nerve MCV and ulnar nerve, median nerve, sural nerve SCV significantly slowed down, the difference was statistically significant (P 0.05). The nerve conduction velocity decreased significantly with the increase of serum NSE level (P 0.05). 9 With DPN as a dependent variable and clinical indicators as an independent variable, multivariate non-conditional logistic regression analysis showed that DPN and course of disease, TG, LDL-C, BMI. Pearson correlation analysis showed that NSE level was positively correlated with LDL-C, TG, Hb A1c, course of disease and FPG (r were 0.654, 0.899, 0.599, 0.852, 0.535, P 0.05 respectively). There was no correlation between NSE level and age, sex (P 0.05). Conclusion 1 The serum NSE level in patients with diabetic peripheral neuropathy was higher than that in patients with diabetes mellitus alone. With the aggravation of DPN, nerve conduction velocity decreased, serum NSE level increased. 3 Serum NSE and course of disease, LDL-C, TG, Hb A1c, FPG were positively correlated.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2
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