CAJ | 학술논문

目的探讨血浆C肽水平变化早期预测2型糖尿病并发周围感觉神经病变的价值.方法 500例2型糖尿病予以震动觉、痛觉、温度觉、触压觉、踝反射检测,根据周围感觉神经检测结果分为四组:正常组(159例)、轻度异常组(120例)、中度异常组(121例)、重度异常组(100例).同时测定其空腹和餐后2h血浆C肽,并与周围感觉神经变化进行分析.制作受试者工作特征(ROC)曲线,找出诊断糖尿病周围感觉神经病变的最佳临界点.结果四组空腹血浆C肽比较差异无统计学意义(F=1.632,P＞ 0.05).餐后2h血浆C肽从正常组到轻度异常组再到中度异常组逐渐增高[(1.110±0.526)、(1.324±0.490)、(1.573±0.716) μg/L],而到重度异常组[(0.910±0.465)μg/L]明显下降且低于正常组,差异均有统计学意义(P＜0.05).当餐后2h血浆C肽为1.173 μg/L时,得到最大约登指数0.366.结论糖尿病并发周围感觉神经病变的早期可能与空腹C肽水平变化关系不大,而与餐后2h血浆C肽水平变化有关.动态观察餐后2h血浆C肽水平变化可能有助于早期发现糖尿病周围感觉神经病变.
목적 탐토혈장C태수평변화조기예측2형당뇨병병발주위감각신경병변적개치.방법 500례2형당뇨병여이진동각、통각、온도각、촉압각、과반사검측,근거주위감각신경검측결과분위사조:정상조(159례)、경도이상조(120례)、중도이상조(121례)、중도이상조(100례).동시측정기공복화찬후2h혈장C태,병여주위감각신경변화진행분석.제작수시자공작특정(ROC)곡선,조출진단당뇨병주위감각신경병변적최가림계점.결과 사조공복혈장C태비교차이무통계학의의(F=1.632,P＞ 0.05).찬후2h혈장C태종정상조도경도이상조재도중도이상조축점증고[(1.110±0.526)、(1.324±0.490)、(1.573±0.716) μg/L],이도중도이상조[(0.910±0.465)μg/L]명현하강차저우정상조,차이균유통계학의의(P＜0.05).당찬후2h혈장C태위1.173 μg/L시,득도최대약등지수0.366.결론 당뇨병병발주위감각신경병변적조기가능여공복C태수평변화관계불대,이여찬후2h혈장C태수평변화유관.동태관찰찬후2h혈장C태수평변화가능유조우조기발현당뇨병주위감각신경병변.
Objective To explore the value of plasma C-peptide levels in early prediction of type 2 diabetes mellitus with peripheral sensory neuropathy.Methods The vibration perception threshold,pain,temperature sensation,touch-pressure sensation,ankle reflex was detected in 500 eases of type 2 diabetes mellitus,and the patients were divided into 4 groups according to peripheral sensory nerve test results:normal group (159 cases),mildly abnormal group (120 cases),moderately abnormal group (121 cases) and severely abnormal group (100 cases).Fasting and 2-hour postprandial C-peptide levels were determined and analysed with peripheral sensory nerve changes.The receiver-operating characteristic (ROC) curve was used to find the best critical point for diagnosis of diabetic peripheral sensory neuropathy.Results The fasting C-peptide among 4 groups had no significant difference (F =1.632,P ＞0.05).Two-hour postprandial C-peptide from normal group to mildly abnormal group and then moderately abnormal group gradually increased [(1.110 ± 0.526),(1.324 ± 0.490),(1.573 ± 0.716) μ g/L],while 2-hour postprandial C-peptide in severely abnormal group was significantly decreased and lower than that in normal group,and there were significant differences (P＜ 0.05).The max Youden Index was 0.366 when 2-hour postprandial C-peptide was 1.173 μ g/L.Conclusions The fasting C-peptide might be not related to early diabetic peripheral sensory neuropathy,but 2-hour postprandial C-peptide might be closely related to early diabetic peripheral sensory neuropathy.It is helpful to detect the early diabetic peripheral sensory neuropathy if we can take a dynamical observation of 2-hour postprandial C-peptide.