CAJ | 학술논문

目的：探讨2型糖尿病患者动态足底压力变化特点及其与周围神经病变程度的关系。方法选取2012年10月-2013年5月在北京军区总医院内分泌科门诊和病房就诊的114例2型糖尿病患者，同时纳入75例健康体检无2型糖尿病者（DC 组）。2型糖尿病患者依据多伦多临床神经病变评分（TCSS）分为无明显周围神经病变组（DM组）、轻度周围神经病变组（DN1组）、中度周围神经病变组（DN2组）和重度周围神经病变组（DN3组），后3组统称为 DN 组。采用比利时 RSsan 平板测试系统检测各组足底部位的动态压力。结果 DC 组足底压力-时间变化曲线呈明显的双峰（M）型，DM 组与 DC 组相比较，峰值差异无统计学意义（P >0.05），谷值增大，差异有统计学意义（P é0.05）；DM 组、DN1组、DN3组足底压力-时间变化曲线依次抬高，峰谷差值依次减小，DN2组足底压力-时间变化曲线较 DM 组低平，且峰谷差值最小。与 DC 组足底压力峰值相比较，DM、DN 组前足底各区（M2、M3、M4、M5）峰值压力变化较大，以 M2、M3区变化明显，M2〔左足分别为（21.1±3.1）、（17.1±4.1）、（19.9±4.3）、（18.9±6.4）、（22.1±5.7） N/ cm2；右足分别为（20.9±2.3）、（16.7±2.9）、（19.8±4.8）、（18.9±5.1）、（22.4±3.6）N/ cm2〕足底峰值压力减小（P é0.05），M3〔左足分别为（18.3±6.2）、（20.4±3.8）、（22.3±4.6）、（20.5±8.4）、（23.2±5.2）N/ cm2；右足分别为（18.9±7.5）、（20.9±3.2）、（22.2±3.7）、（21.6±7.6）、（23.5±8.3） N/ cm2〕足底峰值压力增大（P é0.05）。其中 DN2组 M2、M3区峰值压力处于 DM 组和 DN1组之间。结论2型糖尿病患者动态足底压力异常改变，并发不同程度周围神经病变时足底压力变化程度不同，有效延缓周围神经病变的发展可预防糖尿病足的发生。
목적：탐토2형당뇨병환자동태족저압력변화특점급기여주위신경병변정도적관계。방법선취2012년10월-2013년5월재북경군구총의원내분비과문진화병방취진적114례2형당뇨병환자，동시납입75례건강체검무2형당뇨병자（DC 조）。2형당뇨병환자의거다륜다림상신경병변평분（TCSS）분위무명현주위신경병변조（DM조）、경도주위신경병변조（DN1조）、중도주위신경병변조（DN2조）화중도주위신경병변조（DN3조），후3조통칭위 DN 조。채용비리시 RSsan 평판측시계통검측각조족저부위적동태압력。결과 DC 조족저압력-시간변화곡선정명현적쌍봉（M）형，DM 조여 DC 조상비교，봉치차이무통계학의의（P >0.05），곡치증대，차이유통계학의의（P é0.05）；DM 조、DN1조、DN3조족저압력-시간변화곡선의차태고，봉곡차치의차감소，DN2조족저압력-시간변화곡선교 DM 조저평，차봉곡차치최소。여 DC 조족저압력봉치상비교，DM、DN 조전족저각구（M2、M3、M4、M5）봉치압력변화교대，이 M2、M3구변화명현，M2〔좌족분별위（21.1±3.1）、（17.1±4.1）、（19.9±4.3）、（18.9±6.4）、（22.1±5.7） N/ cm2；우족분별위（20.9±2.3）、（16.7±2.9）、（19.8±4.8）、（18.9±5.1）、（22.4±3.6）N/ cm2〕족저봉치압력감소（P é0.05），M3〔좌족분별위（18.3±6.2）、（20.4±3.8）、（22.3±4.6）、（20.5±8.4）、（23.2±5.2）N/ cm2；우족분별위（18.9±7.5）、（20.9±3.2）、（22.2±3.7）、（21.6±7.6）、（23.5±8.3） N/ cm2〕족저봉치압력증대（P é0.05）。기중 DN2조 M2、M3구봉치압력처우 DM 조화 DN1조지간。결론2형당뇨병환자동태족저압력이상개변，병발불동정도주위신경병변시족저압력변화정도불동，유효연완주위신경병변적발전가예방당뇨병족적발생。
Objective To investigate the plantar pressure distribution changes in type 2 diabetic patients and the rela-tionship with the degree of diabetic peripheral neuropathy. Methods A total of 114 patients with T2DM(who visited our endocri-nology department between October,2012 and May,2013) and 75 healthy people( DC group)were recruited. According to TCSS,T2DM were divided into diabetic control group(DM group),mild diabetic peripheral neuropathy group(DN1 group), moderate diabetic peripheral neuropathy group(DN2 group),severe diabetic peripheral neuropathy group( DN3 group),the last three groups together being called DN group. Plantar pressure of all groups was recorded by RSsan systerm produced by Bel-gium. Results The plantar pressure time curve of healthy people was obvious double - peak type(M),there was no statistical significant difference between DM group and DC group in the plantar peak pressure(P > 0. 05),and when the valley value in-creased,the difference was statistically significant(P é 0. 05). The plantar pressure time curve of DM group、DN1 group and DN3 group rose successively,and the difference between peak and valley decreased successively. The plantar pressure time curve of DN2 group was lower than the DM group,and the difference between peak and valley was the smallest in all. Compared with the DC group,s plantar peak pressure,the region of the forefoot(M2、M3、M4、M5)had a significant change,especially the M2、M3 region. The plantar peak pressure in M2〔Left foot respectively were(21. 1 ± 3. 1)、(17. 1 ± 4. 1)、(19. 9 ± 4. 3)、(18. 9 ± 6. 4)and(22. 1 ± 5. 7)N/ cm2;right foot respectively were(20. 9 ± 2. 3)、(16. 7 ± 2. 9)、(19. 8 ± 4. 8)、(18. 9 ± 5. 1)and(22. 4 ± 3. 6)N/ cm2〕region was decreased(P é 0. 05),and the plantar peak pressure in M3〔Left foot respec-tively were(18. 3 ± 6. 2)、(20. 4 ± 3. 8)、(22. 3 ± 4. 6)、(20. 5 ± 8. 4)and(23. 2 ± 5. 2)N/ cm2;right foot respectively were(18. 9 ± 7. 5)、(20. 9 ± 3. 2)、(22. 2 ± 3. 7)、(21. 6 ± 7. 6)and(23. 5 ± 8. 3)N/ cm2 〕region was increased(P é 0. 05). The plantar peak pressure in M2、M3 region of DN2 group was between DM group and DN1 group. Conclusion Abnor-mal changes of dynamic plantar pressure is found in patients with type 2 diabetes. When merging different degree of peripheral neuropathy,plantar pressure changes at different levels. Effective delay of the peripheral neuropathy development can prevent the occurrence of diabetic foot.