摘要
目的探讨2型糖尿病患者周围神经病变(DPN)的危险因素。方法回顾性分析2019年4月至2020年6月在新乡医学院第三附属医院就诊的198例2型糖尿病(T2DM)患者的临床资料。依据《中国2型糖尿病防治指南(2017版)》中DPN的诊断标准将患者分为T2DM合并周围神经病变组(DPN组)和无病变组(非DPN组),采用单因素分析DPN相关危险因素,采用logistic回归分析DPN的危险因素,绘制受试者工作特征(ROC)曲线评估危险因素对DPN的预测价值。结果共纳入198例T2DM患者,其中合并DPN 110人。与非DPN组比较,DPN组患者年龄较大,病程较长(P<0.05),肌酐胱抑素C比值(CCR)、体质量指数(BMI)下降(P<0.05)。二元logistic回归分析表明,病程延长、CCR下降是DPN的危险因素(P<0.05);病程、CCR预测T2DM发生DPN的最佳截断值分别为4.5 a,0.809;当病程>4.5 a,CCR小于0.809时易合并DPN。病程预测T2DM发生DPN的曲线下面积(AUC)为0.71,CCR预测T2DM发生DPN的AUC为0.633,病程联合CCR发生DPN的AUC为0.727。结论除病程延长外,CCR下降也与糖尿病周围神经病变发生风险升高有关。CCR联合病程对于预测DPN发生的临床诊断价值较高,且较单个危险因素预测价值高。
Objective To analyze the risk factors of diabetic peripheral neuropathy(DPN)in patients with type 2 diabetic mellitus(T2DM).Methods The clinical data of 198 patients with T2DM who were admitted to the Third Affiliated Hospital of Xinxiang Medical University from April 2019 to June 2020 were retrospectively analyzed.They were divided into diabetic peripheral neuropathy group and non-diabetic peripheral neuropathy group by Chinese type 2 diabetes prevention guide(2017 edition)in the diagnosis of DPN standards.Single factor analysis and logistic regression analysis were used to analyze the risk factors of DPN.The receiver-operating characteristic curve(ROC curve)was used to predict the assessment value of risk factors on DPN.Results Among 198 T2DM patients,there were 110 patients with DPN.The age of DPN group was older,the disease duration was longer than those in non-DPN group(P<0.05).The creatinine cystatin C ratio(CCR)and body mass index(BMI)of DPN group were lower than those in non-DPN group(P<0.05).Binary logistic regression analysis showed that increased disease duration and decreased CCR index were the risk factors for T2DM(P<0.05).The best cutoff values of disease course and CCR index for predicting the occurrence of DPN in T2DM were 4.5 years and 0.809.The area under curve(AUC)of disease course of DPN was 0.71,the AUC of CCR index of DPN was 0.633,and the AUC of DPN was 0.727 when the CCR index was combined with the course.Conclusion In addition to the course of disease,CCR index is also associated with increased risk of DPN.CCR combined with disease course have higher clinical diagnostic value than single risk factor.
作者
杨俊
翁孝刚
YANG Jun;WENG Xiaogang(The Third Affiliated Hospital of Xinxiang Medical University/Department of endocrinology,the Third Clinical College of Xinxiang Medical University,Xinxiang 453003,China)
出处
《河南医学研究》
CAS
2021年第20期3688-3691,共4页
Henan Medical Research
