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目的检测糖尿病周围神经病变患者血清缺氧诱导因子-1α(HIF-1α)、髓鞘碱性蛋白(MBP)、超敏C反应蛋白(hs-CRP)和氧化应激反应水平,分析其相关性。方法选择2015年7月~2016年7月在新疆医科大学第五附属医院(以下简称“我院”)接受治疗的糖尿病周围神经病变患者90例为研究组,选择同期在我院体检的年龄、性别相匹配的健康人群80名为对照组。检测两组一般生化指标、血清HIF-1α、MBP、hs-CRP及超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)氧化应激指标水平。糖尿病周围神经病变发生的影响因素采用多因素Logistic回归分析。研究组患者血清HIF-1α、MBP、hs-CRP与SOD、GSH、MDA的相关性分析采用Spearman相关性检验。结果研究组总胆固醇(TC)、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、空腹胰岛素(FINS)水平均明显高于对照组(P﹤0.05)。研究组血清HIF-1α、MBP、hs-CRP水平均明显高于对照组,差异有统计学意义(P﹤0.05)。研究组血清SOD、GSH水平均明显低于对照组(P<0.05),MDA水平明显高于对照组(P<0.05)。多因素Logistic分析表明,年龄、糖尿病病程、TC、TG、FPG、HbA_(1c)、FINS、HIF-1α、MBP、hs-CRP、MDA是糖尿病周围神经病变发生的独立危险因素(P<0.05),SOD、GSH是糖尿病周围神经病变的保护性因素(P<0.05)。Spearman相关检验分析显示,研究组血清HIF-1α、MBP、hs-CRP均与MDA水平呈正相关(r=0.547、0.624、0.685,P<0.05),均与SOD、GSH水平呈负相关(r=-0.565、-0.583、-0.592,r=-0.492、-0.551、-0.572,均P<0.05)。结论血清HIF-1α、MBP、hs-CRP水平的上升和氧化应激反应均参与糖尿病周围神经病变的发生及发展,可能成为临床辅助诊断糖尿病周围神经病变患者的生物指标,为临床干预治疗提供理论依据。
Objective To detect the levels of serum hypoxia inducible factor-1α (HIF-1α), myelin basic protein (MBP), hs-CRP and oxidative stress in patients with diabetic peripheral neuropathy and to analyze their correlation . Methods From July 2015 to July 2016, 90 patients with diabetic peripheral neuropathy undergoing treatment in the Fifth Affiliated Hospital of Xinjiang Medical University (hereinafter referred to as “hospital”) were selected as the study group. 80 healthy people aged and sex matched as the control group. The levels of HIF-1α, MBP, hs-CRP and SOD, GSH and MDA in serum were measured in two groups. The influencing factors of diabetic peripheral neuropathy were analyzed by multivariate logistic regression analysis. The correlation analysis of serum HIF-1α, MBP, hs-CRP, SOD, GSH and MDA in study group was carried out by Spearman correlation test. Results The levels of total cholesterol (TC), triglyceride (TG), fasting blood glucose (FPG), HbA 1c and FINS in the study group were significantly higher than those in the control group (P <0.05). The levels of serum HIF-1α, MBP and hs-CRP in the study group were significantly higher than those in the control group (P <0.05). The levels of serum SOD and GSH in the study group were significantly lower than those in the control group (P <0.05), and the levels of MDA in the study group were significantly higher than those in the control group (P <0.05). Multivariate logistic analysis showed that age, duration of diabetes, TC, TG, FPG, HbA 1c, FINS, HIF-1α, MBP, hs-CRP and MDA were the independent risk factors of diabetic peripheral neuropathy (P < , SOD, GSH were protective factors of diabetic peripheral neuropathy (P <0.05). Spearman correlation analysis showed that the serum levels of HIF-1α, MBP and hs-CRP were positively correlated with MDA levels (r = 0.547,0.624,0.685, P <0.05) and negatively correlated with the level of SOD and GSH (r = -0.565, -0.583, -0.592, r = -0.492, -0.551, -0.572, all P <0.05). Conclusions The increase of serum HIF-1α, MBP, hs-CRP levels and oxidative stress are involved in the occurrence and development of diabetic peripheral neuropathy and may be the biological indicators for the clinical diagnosis of diabetic peripheral neuropathy, providing theory for clinical intervention in accordance with.