CAJ | 학술논문

目的：探讨血清神经元特异性烯醇化酶（NSE）水平变化对糖尿病周围神经病变（DPN）早期诊断的应用价值。方法收集160例2013年1月～2014年12月的糖尿病患者，依据2009年的 DPN 诊断诊疗规范，分为并发周围神经病变者（DPN 组）120例，未并发周围神经病变者（DM 组）40例，并以多伦多临床评分系统（TCSS）评分进行神经病变严重程度的分级，分为轻度、中度、重度 DPN，另选健康对照组160例。采用化学发光免疫法测定血清 NSE 含量，分析 DPN 组患者NSE 水平与 DM 组、对照组的关系，以及不同血糖水平分组、不同 TCSS 评分分级的 DPN 患者之间 NSE 的含量关系。结果DPN 组、DM 组、对照组血清 NSE 水平（μg／L）分别为23.5±3.0，12.4±2.3和11.3±1.6，DPN 和其他两组差异有统计学意义（t＝12.312，14.523，P ＜0.05）；血糖水平3.9～6.1，6.1～8.0和≥8.0 mmol／L，三组 DPN 患者的 NSE 水平（μg／L）依次为22.1±1.6，23.6±1.2和25.0±1.5，差异有统计学意义（t ＝4.021～7.534，P 值均＜0.05）；TCSS 评分对 DPN组神经病变分级后，轻度、中度、重度 DPN 患者血清 NSE 水平（μg／L）分别为21.6±1.1，23.1±1.5和25.2±1.3，差异有统计学意义（t＝3.320～5.526，P 值均＜0.05）；NSE 水平与 TCSS 分值呈正相关（r＝0.572，P ＜0.05）。结论血清 NSE水平高低和糖尿病患者周围神经病变密切相关，可作为 DPN 早期诊断的重要指标。
목적：탐토혈청신경원특이성희순화매（NSE）수평변화대당뇨병주위신경병변（DPN）조기진단적응용개치。방법수집160례2013년1월～2014년12월적당뇨병환자，의거2009년적 DPN 진단진료규범，분위병발주위신경병변자（DPN 조）120례，미병발주위신경병변자（DM 조）40례，병이다륜다림상평분계통（TCSS）평분진행신경병변엄중정도적분급，분위경도、중도、중도 DPN，령선건강대조조160례。채용화학발광면역법측정혈청 NSE 함량，분석 DPN 조환자NSE 수평여 DM 조、대조조적관계，이급불동혈당수평분조、불동 TCSS 평분분급적 DPN 환자지간 NSE 적함량관계。결과DPN 조、DM 조、대조조혈청 NSE 수평（μg／L）분별위23.5±3.0，12.4±2.3화11.3±1.6，DPN 화기타량조차이유통계학의의（t＝12.312，14.523，P ＜0.05）；혈당수평3.9～6.1，6.1～8.0화≥8.0 mmol／L，삼조 DPN 환자적 NSE 수평（μg／L）의차위22.1±1.6，23.6±1.2화25.0±1.5，차이유통계학의의（t ＝4.021～7.534，P 치균＜0.05）；TCSS 평분대 DPN조신경병변분급후，경도、중도、중도 DPN 환자혈청 NSE 수평（μg／L）분별위21.6±1.1，23.1±1.5화25.2±1.3，차이유통계학의의（t＝3.320～5.526，P 치균＜0.05）；NSE 수평여 TCSS 분치정정상관（r＝0.572，P ＜0.05）。결론혈청 NSE수평고저화당뇨병환자주위신경병변밀절상관，가작위 DPN 조기진단적중요지표。
Objective To investigate application value of changes in serum neuron-specific enolase (NSE)in early diagnosis of diabetic peripheral neuropathy (DPN).Methods 160 cases of diabetes were recruited from January 2013 to December 2014, 120 of which were combined with DPN according to the 2009 “DPN Diagnostic & Treatment Guidelines”(the DPN group), and the other 40 were not (the DM group).Patients were further stratified into mild,moderate,and severe DPNs according to the Toronto Clinical Scoring System (TCSS).Another 160 healthy subjects were recruited as control.Serum NSE level was determined by chemiluminescence immunoassay,and was compared among the DPN group,the DM group,and the con-trol group.Serum NSE levels were also compared among DPN patients with different serum glucose levels and different TC-SS grading.Results Serum NSE levels (μg/L)of the DPN group,DM group,and control group were 23.5±3.0,12.4±2.3 and 11.3±1.6 respectively,and the difference between DPN and the other two groups was significant (t=12.312,14.523, P <0.05).DPN patients with serum glucose levels of 3.9~6.1,6.1 ~8.0,and ≥8.0 mmol/L had NSE levels of 22.1 ± 1.6,23.6±1.2 and 25.0±1.5 respectively,and the difference was significant (t =4.021 ~ 7.534,P <0.05 for all).DPN patients with mild,moderate,and severe DPN had NSE levels of 21.6±1.1,23.1±1.5,25.2±1.3,and the difference was significant (t=3.320~5.526,P <0.05 for all).NSE level was positively correlated with TCSS score (r=0.572,P <0.05). Conclusion Serum NSE level is closely correlated with DPN,and can be used as a key indicator for early diagnosis of DPN.