·糖尿病神经病变·

　　【摘要】 目的 探讨糖尿病周围神经病变(DPN)的相关危险因素及神经损害特点。方法 根据神经传导速度(NCV)将T2DM患者分为DPN组和NDPN组，分析各组糖尿病病程、BP、FPG、HbA1c、血脂,以及体感诱发电位等。结果 年龄、病程是DPN发生的危险因素(OR=1.096、1.121,P<0.05)。SBP、FPG、TG、TC与DPN呈正相关,但差异无统计学意义(P>0.05)。HDL-C为DPN的保护因素(OR=2.013,P<0.05)。粗有髓鞘神经纤维及细有髓鞘神经纤维病变组HDL-C水平下降(P<0.05)，且下肢细有髓神经纤维是DPN的好发部位。结论 糖尿病患者增龄、病程长是DPN的危险因素，HDL-C降低与糖尿病周围神经病变的发生发展密切相关。

　　【关键词】糖尿病，2型;周围神经病变;高密度脂蛋白胆固醇

Nerve damage of diabetic peripheral neuropathy and related factors    HE Guang-yu, SUN Cheng-lin, LIU Yu-jia,et al.Department of Endocrinology and Metabolism，the First Hospital of Jilin University, Changchun 130021,China

Corresponding author: WANG Gui-xia, Email: gxwang6688 @yahoo.com

　　【Abstract】 Objective To investigate the related factors of diabetic peripheral neuropathy(DPN) and characteristics of nerve injury. Methods Patients of T2DM were divided into DPN group and NDPN group according to nerve conduction velocity. Diabetes duration, fasting plasma glucose(FPG)，glycosylated hemoglobin(HbA1c), body mass index(BMI), blood pressure, blood lipids, somatosensory evoked potential of each group were analyzed. Results Age and diabetes duration were the risk factors of DNP (OR=1.096,1.121,P<0.05);systolic blood pressure(SNP),FPG, triglycerides(TG),total cholesterol(TC) had positive correlations with DNP possibly, but without significant differentiation (P>0.05); High density lipoprotein-cholesterol(HDL-C) was the protective factor of DPN(OR=2.013, P<0.05).Compared with NDPN group, HDL-C level decreased obviously in patients with both thick and thin myelinated nerve fibers damage (P<0.05). The predilection sites of DNP were thin myelinated nerve fibers of lower limbs (P<0.01). Conclusion Diabetic duration, age were identified as risk factors for DPN, lower HDL-C was closely related to occurring and developing of DPN.

　　【Key words】 Diabetes mellitus，type 2;Peripheral neuropathy;High-density lipoprotein cholesterol(HDL-C)