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目的探讨严格控制血糖对糖尿病周围神经病变的影响。方法选择2009年1月-2010年1月收治的2型糖尿病患者124例,所有患者都无明显周围神经病变症状,随机分成强化组与对照组各62例,对强化组患者进行严格的血糖控制,即使糖化血红蛋白(hemoglobin A1c,HbA1c)<7%,对常规组采取常规的血糖控制,即使HbA1c控制在8%之内。对两组患者进行2年随访,定期观察血糖水平,同时观察两组患者随访前后的末梢感觉定量测定(quantitative sensory test,QST)。计量资料采用t检验,计数资料采用χ2检验,以P<0.05为差异有统计学意义。结果末梢感觉的QST神经都有不同程度的减退,但强化组QST减退程度明显低于常规组,差异有统计学意义(P<0.05)。结论强化控制血糖可明显改善糖尿病患者的周围神经病变,故对2型糖尿病患者应加强血糖控制。
Objective To investigate the effect of strict control of blood glucose on diabetic peripheral neuropathy. Methods 124 patients with type 2 diabetes mellitus were selected from January 2009 to January 2010. All patients had no obvious symptoms of peripheral neuropathy and were randomly divided into two groups, 62 cases in the intensive group and the control group. Patients in the intensive group were treated with strict glycemic control , Even with hemoglobin A1c (HbA1c) <7%, conventional glycemic control was administered to the usual group, even though HbA1c was controlled within 8%. Two groups of patients were followed up for 2 years. Blood glucose level was observed regularly. Quantitative sensory test (QST) was performed before and after follow-up. Measurement data using t test, count data using χ2 test to P <0.05 was considered statistically significant. Results Peripheral sensation of QST neuron decreased to some degree, but the degree of QST decrease in the intensive group was significantly lower than that in the conventional group (P <0.05). Conclusion Intensive control of blood glucose can significantly improve peripheral neuropathy in patients with type 2 diabetes mellitus, and therefore should be strengthened in patients with glycemic control.