摘要
目的探讨老年2型糖尿病(T2DM)周围神经病变(DPN)与血清趋化因子调节激活正常T细胞表达和分泌因子(RANTES)、C-X-C基序趋化因子配体12(CXCL12)、C-C基序趋化因子配体2(CCL2)的关系。方法选取2019年3月~2021年10月河北省邯郸市人民医院确诊的老年T2DM患者181例,根据是否并发DPN将其分为单纯T2DM组(89例)和DPN组(92例)。收集所有患者一般临床资料、实验室检查指标、血清趋化因子RANTES、CXCL12、CCL2水平及感觉神经传导速度和运动神经传导速度并分组进行比较。采用Pearson相关分析评估DPN患者血清趋化因子RANTES、CXCL12、CCL2水平与一般临床指标及神经传导速度的相关性;采用多因素logistic回归分析评估DPN发病的影响因素。结果DPN组血清趋化因子RANTES、CXCL12、CCL2、糖化血红蛋白(HbA1c)、总胆固醇(TC)水平及T2DM病程、高血压病、高脂血症、视网膜病变患者比例均显著高于单纯T2DM组,高密度脂蛋白胆固醇(HDL-C)、感觉神经传导速度、运动神经传导速度均显著低于单纯T2DM组(P<0.05)。Pearson相关分析结果显示,DPN患者血清趋化因子RANTES、CXCL12、CCL2水平与T2DM病程、高血压病、高脂血症、视网膜病变、HbA1c、TC均呈正相关,与HDL-C、感觉神经传导速度、运动神经传导速度均呈负相关(P<0.05)。多因素logistic回归分析结果显示,RANTES、CXCL12、CCL2水平高、T2DM病程长是T2DM患者并发DPN的独立危险因素(P<0.05)。结论DPN患者血清趋化因子RANTES、CXCL12、CCL2水平升高,且与神经传导速度呈负相关。
Objective To investigate the relationship between elderly type 2 diabetic mellitus(T2DM)peripheral neuropathy(DPN)and serum chemokines regulate upon activation normal T cell expressed and secreted(RANTES),C-X-C motif chemokine ligand 12(CXCL12)and C-C motif chemokine ligand 2(CCL2).Methods A total of 181 elderly T2DM patients diagnosed in Handan People’s Hospital of Hebei Province from March 2019 to October 2021 were selected and divided into pure T2DM group(89 cases)and DPN group(92 cases)based on whether they were complicated with DPN.General clinical data,laboratory examination indexes,levels of serum chemokine RANTES,CXCL12,CCL2,sensory nerve conduction velocity and motor nerve conduction velocity of all patients were collected and compared between groups.Pearson correlation analysis was used to evaluate the correlation between serum chemokine RANTES,CXCL12,--CCL2 levels and general clinical indicators,nerve conduction velocity in DPN patients.Multivariate logistic regression analysis was used to evaluate the influencing factors of DPN.Results Serum chemokines RANTES,CXCL12,CCL2,glycated hemoglobin A1 c(HbA1 c),total cholesterol(TC)level and duration of T2DM,the proportion of hypertension,hyperlipidemia,retinopathy in DPN group were all significantly higher than those in pure T2DM group,while high-density lipoprotein cholesterol(HDL-C),sensory nerve conduction velocity and motor nerve conduction velocity were significantly lower than those in pure T2DM group(P<0.05).Pearson correlation analysis showed that the levels of serum chemokines RANTES,CXCL12 and CCL2 in DPN patients were positively correlated with duration of T2DM,hypertension,hyperlipidemia,retinopathy,HbA1c,TC and negatively correlated with HDL-C,sensory nerve conduction velocity and motor nerve conduction velocity(P<0.05).Multivariate logistic regression analysis showed that high levels of RANTES,CXCL12,CCL2 and long duration of T2DM were independent risk factors for DPN in T2DM patients(P<0.05).Conclusion Levels of serum chemokines RANTES,CXCL12 and CCL2 are increased in patients with DPN,and negatively correlated with nerve conduction velocity.
作者
高娟梅
柴小磊
崔茜
赵利波
Gao Juanmei;Chai Xiaolei;Cui Qian;Zhao Libo(First Department ofNeurology,Handan People’s Hospital,Handan 056001,China)
出处
《临床内科杂志》
CAS
2023年第8期525-528,共4页
Journal of Clinical Internal Medicine
基金
河北省医学科学研究课题计划(20200196)。
