·糖尿病神经病变·

　　【摘要】 目的 探讨糖尿病周围神经病变(DPN)患者血清基质细胞衍生因子-1α(SDF-1α)水平改变及鼠神经生长因子(MNGF)对其影响。 方法 选取T2DM 患者180例，根据有无DPN分为DPN组92例和T2DM未合并DPN(T2DM)组88例。另选同期体检健康者90名作为健康对照(NC)组。将DPN组进一步分为MNGF治疗(A)亚组47例和基础治疗(B)亚组45例。检测各组血清SDF-1α水平，分析其与超氧化物歧化酶(SOD)、转化生长因子-β1(TGF-β1)、高敏C反应蛋白(hsC-RP)、神经生长相关蛋白-43(GAP-43)的关系。观察MNGF治疗前后两亚组血清SDF-1α水平的变化。 结果 血清SDF-1α水平由低到高依次为NC、DPN、T2DM组[(0.91±0.37) vs (1.71±0.43) vs (2.58±0.58)μg/L，P<0.05或P<0.01]。Pearson相关性分析结果显示，T2DM组血清SDF-1α水平与FPG、HbA1c、TGF-β1和hsC-RP呈正相关，与SOD呈负相关;DPN组血清SDF-1α水平与TG、TGF-β1呈正相关，与病程、FPG、HbA1c、SOD、hsC-RP、GAP-43、正中神经运动神经传导速度(MMCV)、腓总神经运动神经传导速度(PMCV)、正中神经感觉神经传导速度(MSCV)、腓总神经感觉神经传导速度(PSCV)呈负相关。A亚组血清SDF-1α水平治疗后较治疗前升高[(1.75±0.39) vs (2.09±0.45)μg/L，P<0.05]，B亚组治疗后与治疗前比较差异无统计学意义[(1.67±0.48) vs (1.71±0.51)μg/L，P>0.05]。多元逐步回归分析结果显示，HbA1c、hsC-RP和腓总神经感觉神经传导速度(PSCV)是SDF-1α的影响因素。 结论 DPN患者SDF-1α水平较T2DM患者低，MNGF增加血清SDF-1α水平。

　　【关键词】 糖尿病周围神经病变;血清基质细胞衍生因子-1α;鼠神经生长因子

　　The changes of serum stromal cell-derived factor-1α in patients with diabetic peripheral neuropathy and the influence of mouse nerve growth factor LIU Yun-tao，PAN Jing-fang，JIAN Lei.Department of Endocrinology，Renhe Hospital of China Three Gorges University，Yichang 443000，China

　　【Abstract】 Objective To investigate the changes of serum stromal cell-derived factor-1α (SDF-1α) in patients with diabetic peripheral neuropathy (DPN) and the influence of mouse never growth factor (MNGF) on the levels of serum SDF-1α. Methods 180 patients with type 2 diabetes (T2DM) were divided into T2DM with DPN (DPN group，n=92) and T2DM without DPN (T2DM group，n=88). 90 healthy people were select as normal control (NC group). DPN group was divided into 47 cases of MNGF treatment (A) subgroup and 45 cases of basic treatment (B) subgroup. The levels of serum SDF-1α were measured using ELISA method. The relationships between the levels of serum SDF-1α and SOD，TGF-β1，hsC-RP，and GAP-43 were analyzed. After treatment，the levels of serum SDF-1α in A and B subgroups were compared. Results Compared with NC group [(0.91±0.37)μg/L]，the levels of serum SDF-1α in T2DM and DPN group were higher [(2.58±0.58) μg/L and(1.71±0.43) μg/L，respectively，P<0.05 or P<0.01]. The levels of SDF-1α were positively correlated with FPG，HbA1c，TGF-β1 and hsC-RP，and negatively correlated with SOD in T2DM group. The levels of SDF-1α were positively correlated with TG and TGF-β1，and negatively correlated with course of disease，FPG，HbA1c，SOD，hsC-RP，GAP-43，MMCV，PMCV，MSCV and PSCV in DPN group. SDF-1α levels were significantly increased after treatment with MNGF in subgroup A [(1.75±0.39) vs (2.09±0.45)μg/L，P<0.05]. There were no significant difference of SDF-1α levels after treatment in subgroup B [(1.67±0.48) vs (1.71±0.51)μg/L，P>0.05]. Multiple stepwise regression analysis showed that HbA1c，hsC-RP and PSCV were the independent factors related with the levels of SDF-1α in DPN patients. Conclusion The levels of serum SDF-1α in DPN patients are lower than in T2DM patients without DPN. MNGF may increase the level of serum SDF-1α.

　　【Key words】 Diabetic peripheral neuropathy(DPN);Stromal cell-derived factor-1α(SDF-1α);Mouse never growth factor(MNGF)