The Early Detection And The Analysis Of Relative Risk Factor In Diabetic Peripheral Neuropathy

Ulcer and gangrene are the main displays of diabetic foot .most younger patient got it because of ulcer. Its capital base is diabetic peripheral neuropathy . Most older patient got diabetic foot because of gangrene caused by peripheral angiopathy. But Lawrence considers that pedal gengrene caused by atheromatosis may take place in nondiabetic old people. So he advocates that we should call fedal neuropathic ulcers resulted from diabetic peripheral neuropathy as diabetic food. The commom chronic complication of diabetes is diabetic peripheral neuropathy and the case rate is at least above thirty percent. DPN is the king pathogenesy of neurogenic ulcer. It can involve nervus sensorialis and motor nerve and antonomic nerve. Nervus sensorialis is the most frequent than the other two. It deprives aesthesia of pedal protection and makes the foot senseless. DPN can evoke leg gagrene and amputation. It affect aeromegalic quality of life severely. About fifteen percent of diabetic will be troubled by pedal ulcer in their whole life. At last, about eighty five percent of them will be forced to amputate. Therefore, early diagnosis and interfering in the risk of diabetic foot will block up the amputation appearing. It have many methods to diagnose and evaluate the condition of DPN now. Such as electrophysiology, piezometry, quantitate sensation examine, nerve biopsy, and so on. Their result are reliable, but most of them are of very high price and time-consuming. They are hard to accept by the patient who are short of money. And we carry out large sample by them difficultly. We used three examinational means in this study. They are 10 gramme nylon silk examine,BioThesiometer mensurable sensation examination,Tip Therm temperature sensation examination.They are easy to be used and to be carried. The prices are cheap. They are suitable to extend in clinical work.Semmes-Weinstein monofilament are made up of a series of different nylon silks with distinct antilinear. They can evaluate the threshold of cuticular pressure. So they often be used to screen the protectant sensation of diabetic foot. The monofilaments have different stands. 5.07/10g monofilament is the most frequently used than the others. The American Bio-Thesiometer inspectoscope is a precision instrument to detect vibratory sensation threshold. It is similar to a tuning fork which can adjust swing by itself.The examination aims directly at deep sensation.Tip Therm temperature superficial sensation inspectoscope is used to examine the diabetic temperature sensation qualitativly. It examines temperature superficial sensation through continuous temperature detection. The three examinatins have a high diagnostic value in diabetic peripheral neuropathy.On the basis of WHO 1999, diabetic diagnostic criteria and typing standard, We selected 80 diabetics (48 males and 32 females) who came to the third medical college of JiLin University from May, 2006 to March, 2007. Age is from 23 to 75 (44.14±12.48) years old. The course of disease was from 1 to 28 (9.81±5.81) years. Eleven cases were of type 1 diabetes and sixty nine cases were of type 2 diabetes. They were excluded from cerebrovascular disease and lumbar spodylosis. There is no ulcer infect cutaneous on their feet. The three examinations were examined in the 80 patients.The patients who have one abnormal examinational result or above one abnormal examinational results are classified in group DPN. They were divided into group DPN (28 males ,20 females) and group NDPN (18 males ,14 females). All people in the study were measured body weight, blood pressure, After the subjects had fasted 12 hours at the time examination, fasting and post-prandial glucose levels, glycosylated hemoglobin, cholesterol-total, serum triglycerides, serum LDL cholesterol, serum HDL cholesterol, aporotein A1 and aporotein B. All measurement data was delivered through means value standard errand ( x±s). We analyzed the two groups through t test, x2 test and multiple linear regression analysis. It has significant difference when p<0.05.The result is fourty eight cases with DPN. There was no difference in grouping (p=0.792), sex (p=0.854), age (p=0.289), post-prandial glucose level (p<0.001), aporotein A1 (p=0.254), aporotein B (p=0.400), serum triglycerides (p=0.930), serum HDL cholesterol (p=0.272) in the two groups (p>0.05). Compared with group NDPN group, there are evident differences in course of diease (p<0.001), fasting glucose level (p<0.001), glycosylated hemoglobin(P<0.001), cholesterol-total (p=0.045), serum LDL cholesterol (p=0.008), systolic blood pressure (p=0.046), body weight (p=0.021).Through the multiple linear regression (α=0.05), the most important factors are glycosylated hemoglobin, course of disease,and fasting glucose levels.In a word, after analyzing the diagnosis and the risk factors of diabetie peripheral neuropathy. We make the conclusions: 10g nylon silk examination,Bio-Thesiometer mensurable sensation examination and Tip Therm temperature sensation examination are of low price. We can operate it easily and carry it conveniently. It is suitable to extend in clinical work to screen DPN. With the study of the three examinations, the incidence of DPN is about sixty percent. glycosylated hemoglobin, course of diease , body weigh , cholesterol-totalserum LDL Cholesterol, systolic blood pressure, fasting glucose level are all its risk factors. The most important influential factors are glycosylated hemoglobin, course of disease, and fasting glucose levels. In the treating diabetes course, we should on guard against the above-mentioned factors and give them active treatment to control those on the ideal levels. So we can reduce the appearance of DPN.