摘要
目的探讨α-硫辛酸联合前列地尔对2型糖尿病周围神经病变患者肌电图、血液流变学、血清炎症因子的影响。方法选取2016年10月至2018年10月辽阳市中心医院内分泌科收治的104例2型糖尿病周围神经病变患者作为研究对象,根据治疗方法不同分为对照组(n=52)和研究组(n=52),对照组采用基础降糖治疗+前列地尔治疗,研究组采用基础降糖治疗+α-硫辛酸联合前列地尔治疗。比较两组的临床疗效,治疗前后正中神经、腓总神经、胫神经的运动传导速度(MCV)其波幅(AMP),正中神经、尺神经、腓肠神经的感觉传导速度(SCV)及其AMP;比较两组治疗前后血液流变学指标(全血低切黏度、全血高切黏度、血浆黏度值和血细胞比容)以及血清炎症因子[高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平。结果研究组治疗总有效率高于对照组[86.54%(45/52)比65.38%(34/52)],研究组疗效优于对照组(P <0.05)。治疗前后正中神经、尺神经、腓肠神经SCV和正中神经、腓总神经、胫神经MCV,正中神经、胫神经、腓肠神经近端和远端AMP以及腓肠神经、正中神经、尺神经AMP,全血低切黏度和高切黏度、血浆黏度值、血细胞比容,hs-CRP、TNF-α和IL-6水平的主效应差异有统计学意义(P <0.05);不考虑测量时间,两组间以上各项指标的主效应差异有统计学意义(P <0.05);各项指标的时点间与组间存在交互作用(P <0.05),两组治疗前后各项指标的变化幅度不同,研究组治疗后各项指标的变化更明显。结论α-硫辛酸联合前列地尔可显著改善糖尿病周围神经病变患者的神经传导速度,减轻炎症反应,提高治疗效果。
Objective To investigate the effects of α-lipoic acid combined with alprostadil on electromyography,hemorheology and serum inflammatory factors in patients with type 2 diabetic peripheral neuropathy.Methods A total of104 patients with type 2 diabetic peripheral neuropathy admitted to the Department of Endocrinology of Liaoyang Central Hospital from Oct.2016 to Oct.2018 were included.According to the treatment methods,they were divided into a control group(treated with basic hypoglycemic therapy + alprostadil treatment,n = 52) and a study group(treated with basic hypoglycemic therapy + α-lipoic acid combined with alprostadil,n = 52).The clinical effect of the two groups was compared;the motor conduction velocity(MCV),amplitude(AMP) of median nerve,common peroneal nerve and tibial nerve,sensory conduction velocity(SCV) and AMP of median nerve,ulnar nerve and sural nerve of the two groups before and after treatment were compared;the hemorheological indexes(whole blood low shear viscosity,whole blood high shear viscosity,plasma viscosity and hematocrit) and serum inflammatory factors[high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6) ]of the two groups before and after treatment were compared.Results The total effective rate of the study group was higher than that of the control group[86.54%(45/52) vs 65.38%(34/52) ],and the effect of the study group was better than that of the control group(P < 0.05).Before and after treatment,the main effects of SCV of median nerve,ulnar nerve,sural nerve and MCV of median nerve,common peroneal nerve and tibial nerve,AMP of proximal and distal end of median nerve,tibial nerve,sural nerve,AMP of sural nerve,median nerve and ulnar nerve,low and high shear viscosity of whole blood,plasma viscosity,hematocrit,hs-CRP,TNF-α and IL-6 levels were statistically significantly different(P < 0.05);regardless of measure time,between the two groups,the main effects of the above indexes were statistically significantly different(P < 0.05);there were interactions between groups and time points in the above indexes(P <0.05),the changing amplitudes of the above indexes of the two groups before and after treatment were different,those of the study group were more obvious.Conclusion α-lipoic acid combined with alprostadil can significantly improve the nerve conduction velocity of patients with diabetic peripheral neuropathy,reduce inflammation and improve the therapeutic effect.
作者
赵丹
周雪
ZHAO Dan;ZHOU Xue(Department of Endocrinology,Liaoyang Central Hospital,Liaoyang 111000,China)
出处
《医学综述》
2020年第21期4354-4359,共6页
Medical Recapitulate
关键词
2型糖尿病
周围神经病变
Α-硫辛酸
前列地尔
肌电图
血清炎症因子
血液流变学
Type 2 diabetes mellitus
Peripheral neuropathy
α-lipoic acid
Alprostadil
Electromyography
Serum inflammatory factors
Hemorheology
