·糖尿病神经病变·

　　【摘要】 目的 观察糖尿病周围神经病变(DPN)患者加用a-硫辛酸后对神经症状及氧化应激反应的作用。 方法 选取DPN患者45例，分为a-硫辛酸联合甲钴胺组17例及单药甲钴胺组28例，比较两组治疗前后神经症状评分(NSS)、神经缺陷评分(NDS)及氧化应激指标水平。 结果 与治疗前相比，治疗后a-硫辛酸联合甲钴胺组NSS得分下降[(4.88±0.94) vs (4.06±0.91)分，P<0.05]，过氧化氢酶(CAT)上升[(33.50±3.60) vs (37.07±6.47)U/L，P<0.05]，丙二醛(MDA)下降[(3.16±0.51) vs (2.77±0.27)mmol/L]，还原型谷胱甘肽(GSH)上升[(82.93±9.55) vs (88.78±13.16) ng/L，P<0.05]，氧化型谷胱甘肽(GSSH)下降[(115.00±23.20) vs (102.25±13.20)ng/L，P<0.05]。单药甲钴胺组仅CAT上升[(34.16±6.47) vs (37.12±5.99) U/L，P<0.05]，MDA、GSH和GSSG 水平治疗前后比较差异无统计学意义。 结论 与单药甲钴胺相比，加用a-硫辛酸可更显著改善DPN患者氧化应激水平，从而更好地改善症状。

　　【关键词】a-硫辛酸;糖尿病周围神经病变;氧化应激

The therapeutic effect of a-lipoic acid in the treatment of diabetic neuropathy ZHAO Li，MA Yu-hang，PENG Yong-de.Department of Endocrinology and Metabolism, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China

Corresponding author：PENG Yong-de，E-mail：pengyongde0908@126.com

　　【Abstract】Objective To study the improvement of neurological symptoms and oxidative stress response in the patients with diabetic peripheral neuropathy (DPN) after be treated by α-lipoic acid. Methods 45 DPN patients were selected and divided into α-lipoic acid plus mecobalamin group 17 patients and mecobalamin group 28 patients. Compared the neuropathy symptom score (NSS), neuropathy disability score (NDS) and the level of oxidative stress products between two groups before and after treatment. Results Comrared with before treatment, NSS was reduced in α-lipoic acid plus mecobalamin group [(4.88±0.94) vs (4.06±0.91)score，P<0.05], CAT was increased [(33.50±3.60) vs (37.07±6.47)U/L，P<0.05], MDA was decreased [(3.16±0.51) vs (2.77±0.27)mmol/L], GSH was increased [(82.93±9.55) vs (88.78±13.16) ng/L，P<0.05], GSSH was decreased [(115.00±23.20) vs (102.25±13.20)ng/L，P<0.05]. Only CAT increased [(34.16±6.47) vs (37.12±5.99) U/L，P<0.05] in mecobalamin group, there were no significant changes in SOD, MDA, GSH and GSSG. Conclusion Compared with mecobalamin group, the treatment with mecobalamin plus α-lipoic acid shows a significant improvement in the level of oxidative stress and symptom relief.

　　【Key words】α-lipoic acid;Diabetic peripheral neuropathy (DPN);Oxidative stress