上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (6): 802-.doi: 10.3969/j.issn.1674-8115.2011.06.026

• 论著（临床研究） • 上一篇    下一篇

2型糖尿病周围神经损害与膝关节骨关节炎严重程度的关系

孙长惠, 岑建平, 陆 炯, 袁拥军, 唐 绮   

  1. 上海交通大学 医学院附属瑞金医院卢湾分院骨科, 上海 200020
  • 出版日期:2011-06-28 发布日期:2011-06-27
  • 作者简介:孙长惠（1966—）, 男, 副主任医师, 硕士；电子信箱: sunsymons@163.com。
  • 基金资助:

    上海市卢湾区科委医疗卫生科研项目(LKW0807)

Relationship between type 2 diabetic peripheral neuropathy and severity of osteoarthritis of knee

SUN Chang-hui, CEN Jian-ping, LU Jiong, YUAN Yong-jun, TANG Qi   

  1. Department of Orthopedics, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai 200020, China
  • Online:2011-06-28 Published:2011-06-27
  • Supported by:

    Foundation from Science and Technology Committee of Luwan District, Shanghai, LKW0807

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摘要：

目的 观察2型糖尿病周围神经损害与膝关节骨关节炎严重程度的关系。方法 选择200例膝关节骨关节炎合并2型糖尿病患者以及171例膝关节骨关节炎无糖尿病患者，X线检查确定膝关节骨关节炎的严重程度，肌电图检测周围神经损害情况，生化自动分析仪测量空腹血糖、餐后2 h血糖、糖化血清蛋白和糖基血红蛋白等糖尿病相关指标，Logistic回归分析糖尿病、糖尿病周围神经损害与膝关节骨关节炎严重程度的相关性。结果 Logistic回归分析显示：是否患糖尿病（OR=1.66, P=0.009）、空腹血糖（OR=2.11, P<0.001)、餐后2 h血糖（OR=1.57, P<0.001)、糖化血清蛋白（OR=1.63, P<0.001)、糖基血红蛋白（OR=2.22, P<0.001) 与膝关节骨关节炎严重程度显著相关；是否患糖尿病与是否存在外周神经损害显著相关（OR=1.73, P<0.001）；是否存在糖尿病周围神经损害与膝关节骨关节炎严重程度显著相关（OR=1.92, P=0.016)，其中周围神经变性（OR=2.2, P=0.008)和周围神经异常（OR=6.35, P=0.029) 与膝关节骨关节炎严重程度显著相关。结论 2型糖尿病周围神经损害与膝关节骨关节炎严重程度可能存在关联，临床症状较轻的严重膝关节骨关节炎可能是由2型糖尿病周围神经损害介导的疼痛感觉减退造成，需引起高度重视。

关键词: 2型糖尿病, 周围神经损害, 骨关节炎

Abstract:

Objective To investigate the relationship between type 2 diabetic peripheral neuropathy and severity of osteoarthritis of knee. Methods Two hundred patients with osteoarthritis of knee and type 2 diabetes mellitus and 171 patients with osteoarthritis of knee and no type 2 diabetes mellitus were selected. The severity of osteoarthritis of knee was determined by X-ray examination, the status of peripheral neuropathy was assessed by electromyography, the diabetes mellitus-related parameters of fasting blood glucose, 2 h post-prandial blood glucose, glycosylated serum protein and glycated hemoglobin were detected by autoanalyser, and the relationship between diabetes mellitus, diabetic peripheral neuropathy and severity of osteoarthritis of knee was evaluated by Logistic regression analysis. Results Logistic analysis revealed that the status of diabetes mellitus （OR=1.66, P=0.009）, fasting blood glucose （OR=2.11, P<0.001), 2 h post-prandial blood glucose （OR=1.57, P<0.001), glycosylated serum protein （OR=1.63, P<0.001) and glycated hemoglobin （OR=2.22, P<0.001) were significantly related to the severity of osteoarthritis of knee. The status of diabetes mellitus was significantly related to the status of peripheral neuropathy （OR=1.73, P<0.001）. The status of diabetic peripheral neuropathy was significantly related to the severity of osteoarthritis of knee （OR=1.92, P=0.016), and diabetic peripheral neural degeneration （OR=2.2, P=0.008) and diabetic peripheral neural abnormality （OR=6.35, P=0.029) were significantly related to the severity of osteoarthritis of knee. Conclusion Type 2 diabetic peripheral neuropathy might be related to the severity of osteoarthritis of knee. The relatively mild symptoms in some patients with severe osteoarthritis might be caused by diabetic peripheral neuropathy, and should be attached greater importance.

Key words: type 2 diabetes mellitus, peripheral neuropathy, osteoarthritis