摘要
目的探究2型糖尿病(type 2 diabetes mellitus,T2DM)引起糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的危险因素及生活方式干预的影响。方法回顾性分析2019年1月至2022年12月联勤保障部队第九一〇医院收治的178例T2DM患者的临床资料,采用统一问卷调查收集患者的临床资料,统计T2DM患者发生DPN的情况,采用单因素及多因素Logistic回归分析T2DM引起DPN的危险因素。将发生DPN患者随机分为常规组与干预组,常规组采取常规护理,干预组接受生活方式干预护理,比较两组神经感觉传导速度、餐后2 h血糖(postprandial blood glucose,2 h PBG)水平及多伦多临床评分系统(Toronto clinical scoring system,TCSS)评分。结果178例T2DM患者中,发生DPN 92例,发生率为51.68%,其中干预组46例,常规组46例。单因素分析结果显示,发生DPN患者年龄、内脏脂肪面积(visceral fat area,VFA)和2 h PBG、糖化血红蛋白A1c(glycated hemoglobin A1c,HbA1c)水平及体重指数(body mass index,BMI)>24 kg/m^(2)、糖尿病持续时间≥5年比例均高于未发生DPN患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,BMI≥24 kg/m^(2)、糖尿病持续时间≥5年、HbA1c≥7.0%、2 h PBG≥15 mmol/L、VFA≥100 cm^(2)为T2DM引起DPN的独立危险因素(P<0.05)。干预后,干预组排肠、正中及尺神经传导速度均快于常规组,差异有统计学意义(P<0.05);干预后,干预组2 h PBG水平及TCSS评分均低于常规组,差异有统计学意义(P<0.05)。结论BMI≥24 kg/m^(2)、糖尿病持续时间≥5年、HbA1c≥7.0%、2 h PBG≥15 mmol/L、VFA≥100 cm^(2)是T2DM引起DPN的危险因素,生活方式干预可改善神经传导速度,减轻DPN严重程度,有利于调节血糖。
Objective To explore the risk factors of diabetic peripheral neuropathy(DPN)caused by type 2 diabetes mellitus(T2DM)and the influence of lifestyle intervention.Methods The clinical data of 178 patients with T2DM admitted to the 910th Hospital of the Joint Logistic Support Force from January 2019 to December 2022 were retrospectively analyzed,the clinical data of patients were collected by using the unified questionnaire survey to statistically analyze the occurrence of DPN in patients with T2DM,univariate and multivariate Logistic regression analyses were used to analyze the risk factors of DPN caused by T2DM.Patients with DPN were randomly divided into the conventional group and the intervention group,the conventional group received conventional care,and the intervention group received lifestyle intervention care,the neurosensory conduction velocity,postprandial blood glucose(2 h PBG)level and Toronto clinical scoring system(TCSS)score were compared between the two groups.Results Among 178 patients with T2DM,92 cases developed DPN,with the incidence rate of 51.68%,among them,there were 46 cases in the intervention group and 46 cases in the conventional group.The results of univariate analysis showed that the age,visceral fat area(VFA),2 h PBG,glycated hemoglobin A1c(HbA1c)level,and the proportion of body mass index(BMI)>24 kg/m^(2),duration of diabetes≥5 years in patients with DPN were all higher than those in patients without DPN,and the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that BMI≥24 kg/m^(2),duration of diabetes≥5 years,HbA1c≥7.0%,2 h PBG≥15 mmol/L,and VFA≥100 cm^(2) were independent risk factors for DPN caused by T2DM(P<0.05).After the intervention,the conduction velocities of the enteral nerve,median nerve and ulnar nerve in the intervention group were all faster than those in the conventional group,and the differences were statistically significant(P<0.05);after the intervention,the 2 h PBG level and the TCSS score in the intervention group were lower than those in the conventional group,the differences were statistically significant(P<0.05).Conclusion BMI≥24 kg/m^(2),duration of diabetes≥5 years,HbA1c≥7.0%,2 h PBG≥15 mmol/L,and VFA≥100 cm^(2) are the risk factors of DPN caused by T2DM,lifestyle intervention can improve nerve conduction velocity,reduce the severity of DPN,and be beneficial to the regulate blood glucose.
作者
朱玲玲
陈润瑶
康珍珍
刘双凤
ZHU Lingling;CHEN Runyao;KANG Zhenzhen;LIU Shuangfeng(Department of Endocrinology,the 910th Hospital of the Joint Support Force,Quanzhou,Fujian,362211,China)
出处
《当代医学》
2025年第2期48-53,共6页
Contemporary Medicine
关键词
2型糖尿病
糖尿病周围神经病变
危险因素
生活方式干预
神经传导速度
Type 2 diabetes mellitus
Diabetic peripheral neuropathy
Risk factors
Lifestyle intervention
Sensory nerve conduction velocity
