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目的探讨皮肤交感反应(SSR)对2型糖尿病患者自主神经病变的临床诊断价值和相关影响因素,并为其预防和干预提供依据。方法选择山东省济宁医院附属医院神经内科2014年4月至10月收治的92例糖尿病患者为研究对象,并选择38例健康者为对照组,92例糖尿病患者为观察组,分别测定两组患者SSR和糖化血红蛋白(Hb A1c)等生化指标,并分析其与SSR异常相关的因素。结果对照组均引出标准SSR,观察组SSR异常57例,异常率为61.96%;观察组SSR潜伏期与对照组相比延长,SSR波幅降低,差异均有统计学意义(P<0.05);糖尿病患者合并DPN与不合并DPN者SSR异常率分别为73.61%、40.00%,有自主神经症状与无自主神经症状SSR异常率分别为68.63%、48.78%,SSR异常率在合并DPN和有自主神经症状者较高,差异均有统计学意义(P<0.05);Logistic多因素回归分析结果表明糖尿病患者SSR异常的独立影响因素是病程(OR=1.378,P=0.043)和Hb A1c(OR=1.429,P=0.041)。结论 SSR对2型糖尿病患者自主神经病变的早期临床诊断具有一定价值,病程和Hb A1c是与2型糖尿病患者SSR异常的相关因素。
Objective To investigate the clinical diagnostic value and related factors of skin sympathetic reaction (SSR) on type 2 diabetic patients with autonomic neuropathy and to provide basis for its prevention and intervention. Methods Ninety-two diabetic patients admitted from April 2014 to October 2014 in Jining Hospital Affiliated Hospital of Shandong Province were enrolled in the study. 38 healthy subjects were selected as control group and 92 diabetic patients as observation group. Two groups of patients SSR and Hb A1c and other biochemical indicators, and analyze the factors associated with SSR abnormalities. Results The control group all had standard SSR. The SSR abnormality in the observation group was 57 cases, the abnormal rate was 61.96%. The SSR latency in the observation group was longer than that in the control group, and the SSR amplitude was lower (P <0.05) The abnormal rates of SSR in patients with and without DPN were 73.61% and 40.00%, respectively. The rates of abnormalities of SSR with and without autonomic symptoms were 68.63% and 48.78%, respectively. The abnormalities of SSR in patients with DPN and autonomic symptoms (OR = 1.378, P = 0.043) and Hb A1c (OR = 1.429, P <0.05). Logistic regression analysis showed that the independent influencing factors of SSR in diabetic patients were the duration of disease = 0.041). Conclusion SSR has some value in the early clinical diagnosis of type 2 diabetic patients with autonomic neuropathy. The course of disease and Hb A1c are related factors of SSR abnormalities in type 2 diabetic patients.