2型糖尿病患者血清神經(jīng)元特異性烯醇化酶水平與糖尿病周圍神經(jīng)病變的關(guān)系
發(fā)布時間：2018-08-12 08:46
【摘要】：目的觀察2型糖尿病患者血清神經(jīng)元特異性烯醇化酶(Neuron specific enolase,NSE)水平,探討其與糖尿病周圍神經(jīng)病變(Diabetic peripheral neuropathy,DPN)的相關(guān)性,為DPN的防治提供理論依據(jù)。方法依據(jù)1999年WHO糖尿病診斷及分型標準選取2013.1-2014.8華北理工大學附屬醫(yī)院內(nèi)分泌科住院的2型糖尿病患者106例,其中男57例,女49例,年齡28-80歲,平均(54.50±10.63)歲。根據(jù)DPN診斷標準將糖尿病患者分為兩組,單純糖尿病組(DM組)56例,其中男30例,女26例,年齡28-80歲,平均(53.73±9.76)歲;糖尿病周圍神經(jīng)病變組(DPN組)50例,其中男27例,女23例,年齡31-79歲,平均(55.36±11.57)歲。又根據(jù)TCSS評分將DPN組分為輕度DPN組;中度DPN組;重度DPN組;所有研究對象均測量周圍神經(jīng)傳導速度、身高、體重、血壓。所有研究對象空腹12h以上,晨起抽取靜脈血檢測血清甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、總膽固醇(TC)、糖化血紅蛋白(Hb A1c)、空腹血糖(FPG)、血清神經(jīng)元特異性烯醇化酶(NSE)水平。所有數(shù)據(jù)分析應用IBM SPSS19.0統(tǒng)計軟件包進行統(tǒng)計分析,計量資料以均數(shù)±標準差(x±s)表示,兩組數(shù)據(jù)之間用t檢驗進行比較;組間率的比較采用χ2檢驗;多組數(shù)據(jù)間比較采用單因素方差分析。指標間相關(guān)性采用Pearson相關(guān)分析,并計算相關(guān)系數(shù)。采用多因素非條件Logistic回歸分析進行DPN危險因素的分析。P0.05為差異有統(tǒng)計學意義。結(jié)果1 DPN組與DM組比較性別構(gòu)成經(jīng)χ2檢驗差異無統(tǒng)計學意義(P0.05),說明本次研究對象的性別構(gòu)成具有可比性。DPN組與DM組年齡比較差異無統(tǒng)計學意義(P0.05)。2 DPN組與DM組病程比較,DPN組高于DM組差異有統(tǒng)計學意義(P0.05)。3 DPN組BMI、SBP、DBP、LDL-C、FPG、Hb A1c、TC、TG水平高于DM組,差異有統(tǒng)計學意義(P0.05)。4 DPN組HDL-C水平低于DM組,差異有統(tǒng)計學意義(P0.05)。5血清NSE水平DPN組高于DM組,隨著DPN程度的加重升高明顯,差異有統(tǒng)計學意義(P0.05)。6 DM組12例血清NSE大于13ug/L,DPN組27例患者血清NSE大于13ug/L,經(jīng)χ2檢驗OR=4.3,說明血清NSE高于正常范圍時,糖尿病患者發(fā)生DPN的危險性增加3.3倍。7 DPN組與DM組NCV比較,尺神經(jīng)、正中神經(jīng)、腓總神經(jīng)、脛神經(jīng)MCV以及尺神經(jīng)、正中神經(jīng)、腓腸神經(jīng)SCV顯著減慢,差異有統(tǒng)計學意義(P0.05)。8將糖尿病患者以血清NSE水平由低到高按四分位間距分組,隨著血清NSE水平升高神經(jīng)傳導速度顯著減慢,組間比較差異有統(tǒng)計學意義(P0.05)。9以是否合并DPN為因變量,以各臨床指標為自變量,行多因素非條件Logistic回歸分析結(jié)果顯示,DPN與病程、TG、LDL-C、BMI、SBP、DBP、Hb A1c、血清NSE呈正相關(guān)(P0.05)。10進行Pearson相關(guān)分析顯示NSE水平與LDL-C、TG、Hb A1c、病程、FPG呈正相關(guān)(r分別為0.654,0.899,0.599,0.852,0.535,P0.05)。與年齡、性別無相關(guān)(P0.05)。結(jié)論1糖尿病周圍神經(jīng)病變患者血清NSE水平高于單純糖尿病患者,并且隨著DPN程度的加重升高明顯。2神經(jīng)傳導速度下降,血清NSE水平升高。3血清NSE和病程、LDL-C、TG、Hb A1c、FPG呈正相關(guān)。
[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.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R587.2
本文編號：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.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R587.2
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