摘要
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.
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.
出处
《中国医师进修杂志》
2014年第16期31-33,共3页
Chinese Journal of Postgraduates of Medicine
关键词
C肽
糖尿病
2型
周围感觉神经病
早期预测
C-peptide
Diabetes mellitus, type 2
Peripheral sensory neuropathy
Early prediction
