【摘要】 目的 探讨T2DM心自主神经病变和外周感觉神经病变之间的关系。方法 选取T2DM患者148例，采集临床资料，测定FPG、HbA1c及LDL-C等生化指标;进行定量感觉神经检查(以色列TSA-II定量感觉神经测定仪)，结合临床症状评价糖尿病外周感觉神经病变;进行心血管反射试验检查，结合临床症状评价糖尿病心自主神经病变。结果 在入组对象中外周感觉神经病变的患病率为28%，心自主神经病变的患病率为10%;无外周感觉神经病变的患者中心自主神经病变的患病率为6%，存在外周感觉神经病变的患者中心自主神经病变的患病率为21%;与对照组相比，外周感觉神经病变组和心自主神经病变组的病程较长，FPG、HbA1c及LDL -C水平较高，差异具有统计学意义(P<0.05)。结论 糖尿病心自主神经病变可发生于无外周感觉神经病变的患者;病程、FPG、HbA1c及LDL-C可能为糖尿病外周感觉神经病变和心自主神经病变的危险因素。

　　【关键词】 糖尿病,2型;心自主神经病变;外周感觉神经病变

　　Relationship between peripheral neuropathy and cardiovascular autonomic neuropathy in type 2 diabetes NIU Ben, SU Heng, LI Chao, et al. Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming 650032, China

　　Corresponding author: SU Heng, E-mail: 921638630@qq.com

　　【Abstract】Objective To investigate the relationship between diabetic cardiovascular autonomic neuropathy and peripheral neuropathy in type 2 diabetes. Methods The clinical data of 148 T2DM patients was collected and the biochemical indices including fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and low density lipoprotein cholesterol (LDL-C) of these patients were determined. The diabetic peripheral neuropathy was diagnosed according to the quantitative sensory test (Neurosensory Analyzer Model TSA-II) and clinical symptoms. The diabetic cardiovascular autonomic neuropathy was estimated with cardiovascular reflex test and clinical symptoms. Results The incidence of diabetic peripheral neuropathy was 28% and that of the cardiovascular autonomic neuropathy 10%. In the patients without diabetic peripheral neuropathy, the incidence of cardiovascular autonomic neuropathy was 6%, while in those with diabetic peripheral neuropathy, the incidence of cardiovascular autonomic neuropathy 21%. Comparing with the control group, the disease duration in the diabetic peripheral neuropathy and cardiovascular autonomic neuropathy groups was longer, and the levels of FPG, HbA1c, and LDL-C were higher with a statistical difference (P<0.05). Conclusion Diabetic cardiovascular autonomic neuropathy can occur in the patients without peripheral neuropathy. The disease duration, FPG, HbA1c, and LDL-C may be the risk factors of diabetic cardiovascular autonomic neuropathy and peripheral neuropathy.

　　【Key words】Diabetes mellitus, type 2; Diabetic cardiovascular autonomic neuropathy; Peripheral neuropathy