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目的通过对2型糖尿病患者3种不同感觉神经亚群受损情况的评估,探讨糖化血红蛋白与糖尿病患者三种不同感觉神经亚群病变的相关性。方法选取该院内分泌科于2015年3月—2016年3月收治住院2型糖尿病患者200例,依据HbA1c数值将所有研究对象分为3组:A组(HbA1c≤7.5%)、B组(7.5%9%)。对比3组患者的感觉神经受损程度以及CPT值。结果粗有髓鞘纤维、细有髓鞘纤维、无髓鞘纤维的神经受损发病率分别为:A组患者:25.0%,37.5%,20.8%;B组患者:40.6%,59.4%,50.1%;C组患者:50.9%,51.9%,49.2%。A组的双侧正中神经-尺神经的无髓鞘纤维的CPT值明显低于B、C组(P<0.05)。C组的双侧正中神经-尺神经的粗有髓鞘纤维的CPT值明显高于A、B两组(P<0.05),A、B两组之间差异无统计学意义。B组的双侧腓浅神经-腓深神经的细有髓鞘纤维的CPT值明显高于A、C两组(P<0.05),A、C两组之间差异无统计学意义。结论血糖控制不达标是感觉神经病变的危险因素,血糖控制越好,感觉神经中粗有髓鞘纤维及无髓鞘纤维获益越大。
OBJECTIVE: To evaluate the relationship between three different types of sensory neural subgroups in patients with type 2 diabetes mellitus (T2DM) and to evaluate the relationship between the three subtypes of NGF and HbA1c in diabetic patients. Methods A total of 200 hospitalized type 2 diabetic patients were enrolled in this hospital from March 2015 to March 2016. All subjects were divided into three groups according to the HbA1c value: group A (HbA1c≤7.5%), group B (7.5 % 9%). The sensory nerve damage and CPT values were compared between the three groups. Results The incidence of nerve damage of crude myelinated fibers, finely myelinated fibers and non-myelinated fibers were 25.0%, 37.5% and 20.8% respectively in group A and 40.6%, 59.4% and 50.1 respectively in group B %; Group C patients: 50.9%, 51.9%, 49.2%. In group A, the CPT of unilateral medial nerve-ulnar nerve without myelinated fiber was significantly lower than that of group B and C (P <0.05). The CPT values of bilateral medial nerve-ulnar nerve fibers in group C were significantly higher than those in groups A and B (P <0.05). There was no significant difference between groups A and B. The CPT of fine myelinated fibers in B group were significantly higher than those in A and C groups (P <0.05). There was no significant difference between A and C groups. Conclusion The non-compliance of glycemic control is a risk factor of sensory neuropathy. The better the control of blood glucose, the more benefit the thick myelinated and non-myelinated fibers in sensory nerve.