糖尿病神经病变

　　【摘要】 目的 探讨糖尿病周围神经病变(DPN)患者血清胱抑素C(Cys-C)水平及其临床意义。 方法 选取T2DM患者219例，其中T2DM未合并周围神经病变者(T2DM组)117例，T2DM合并周围神经病变者(DPN组)102例，另选健康对照者(NC组)47例，检测各组血清Cys-C水平。 结果 DPN组血清Cys-C水平高于NC、T2DM组(P<0.05)，T2DM组与NC组间比较差异无统计学意义。在肾小球滤过率相似的情况下，随着血清Cys-C水平升高，正中神经潜伏期呈逐渐延长趋势，运动传导波幅和腓肠神经的感觉神经传导速度(SCV)呈逐渐下降趋势。Logistic多元逐步回归分析显示，病程长，FPG、HbA1c和血清Cys-C水平升高，均可能增加T2DM患者DPN风险。 结论 血清Cys-C水平与DPN发生关系密切。

　　【关键词】血清胱抑素C;糖尿病，2型;糖尿病周围神经病变

　 【Abstract】 Objective To investigate the correlation between serum cystatin- C (Cys-C) level and diabetic peripheral neuropathy (DPN) in T2DM patients. Methods 219 T2DM patients were selected, divided into two groups：T2DM patients without DPN (T2DM group，n=117) and with DPN (DPN group，n=102)， and 47 healthy subjects as controls (NC group). Serum Cys-C level was measured by microparticle enhanced turbidimetry. Results The serum Cys-C level was higher in DPN group than in NC and T2DM group(P<0.05). However, there was no difference in serum Cys-C levels between T2DM and NC group. In the condition of similar glomerular filtration rate, along with the gradual increase of serum Cys-C level, the median nerve latency increased, sural nerve motor conduction and amplitude of SCV decreased gradually. Multivariate logistic regression analysis revealed that the prolonged disease course, elevated serum Cys-C levels, higher HbA1c and elevated FPG were the risk factors for DPN in T2DM patients. Conclusion The serum level of Cys-C is related to the occurrence of DPN in T2DM.

　　【Key words】Serum cystatin-C (Cys-C);Diabetes mellitus，type 2;Diabetic peripheral neuropathy (DPN)