糖尿病患神經病變的危險因子相關性研究

糖尿病患神經病變的危險因子相關性研究

 本研究之目的為探討台灣地區糖尿病患神經病變的危險因子相關性研究。本研究以省立新 竹醫院的糖尿病門診病患共 813 人為研究對象。資料收集包括基本資料、病歷抄錄及神經 病變問卷。資料收集期間為民國 85 年 7 月至 86 年 3 月。資料收集包括電話訪視病患的基本資 料，年齡、性別、父母親的氏族、糖尿病患被診斷出糖尿病的年齡、如何被診斷出糖尿病

、目前控制糖尿病的方法、抽煙、高血壓、家族史。病歷抄錄 84 年至 86 年的血清生化檢驗

，包括血糖值、血壓值、肌干酸值、包括感覺、運動及自主神經病變的標準症狀。本研究 共有 390 (47.85%) 位病患有神經病變症狀，分析結果發現年齡、被診斷出糖尿病時的年 齡、罹患糖尿病的年數、使用胰島素的年數、使用胰島素治療等，和神經病變有相關性。

本研究中雖未發現血糖控制和神經病變有相關。但患有高血壓、高血脂、心臟病、中風及 痛風者神經病變相對危險性顯著偏高，且隨著神經病變症狀嚴重性的增加，罹患高血壓、

高血脂、心臟病、中風及痛風的危險性也隨之增加。以 Generalized Estimating Equatio ns (GEE) model 模式對數複迴歸分析發現年齡、檢驗次數、天門冬胺酸基轉移酵素、高 血壓、高血脂、心臟病及高尿酸為糖尿病神經病變重要的危險因子。

The study on risk factors of diabetic neuropathy

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The purpose of this study is to analyze the relationship between the risk factors of diabetic neu ropathy in Taiwan. Eight hundred and thirteen (813) diabetic of Provincial Hsinchu Hospital were as subjects. The collected data included basic information, history record and the neurop athy questionnaire. The data collection period was from July 1996 to March 1997. The collect ed data by telephone asking included: patient basic information, age, sex, parent family, the ag e diagnosed as diabetes, current diabetic

control method, smoking custom, hypertension and family history. Collection of serum bioche mistry record of history from 1885 to 1997 included following items: blood glucose, blood pre ssure, creatinine, triglyceride, cholesterol, glycohemoglobin and high density lipoprotein. The neuropathy questionnaire was done by telephone asking the subjects for the neuropath includi ng feeling, motion and standard clinic sign of autonomic neuropathy. There were three hundre d and ninety (390)(47.5%) subjects had neuropathy.

The analysis result indicated that the neuropathy was associated with the age, the aged diagnos ed as diabetes, the years got the diabetes, the years using insulin and the years receiving insuli n treatment. The result did not find the blood glucose control was associated with the neuropat hy. The neuropathic relative risk of subjects with hypertension, hyperlipemia, cardiopathy, str oke or gout was significantly higher and increased by the severity of neuropathy. The analysis result by the multiple logistic reg

ression of generalized estimation equations (GEE) model indicated that the important risk fact

ors of diabetic neuropathy included age, inspection times, Asparagine transferase, hypertensio

n, hyperlipemia and cardiopathy