α-硫辛酸在糖尿病周围神经病变治疗中 对氧化应激的改善作用

谭娅琴+杨香菊+廖庆辉+万新红+陈玉华

【摘要】目的探讨α-硫辛酸在二甲双胍治疗糖尿病周围神经病变中对患者氧化应激的改善作用。方法50例糖尿病周围神经病变患者随机分为治疗组和对照组各25例, 治疗组给予二甲双胍联合α-硫辛酸治疗；对照组给予二甲双胍治疗。比较两组治疗前后感觉神经传导速度(SCV)的变化。结果两组治疗后正中神经和腓神经的SCV均高于治疗前, 且治疗组高于对照组, 差异有统计学意义(P<0.05)。α-硫辛酸能降低血清中丙二醛(MDA)水平并提高超氧化物歧化酶(SOD)水平。结论α-硫辛酸能改善糖尿病周围神经病变, 这可能是通过改善氧化应激来实现的。

【关键词】糖尿病周围神经病变；α-硫辛酸；氧化应激

Effect of alpha-lipoic acid in relieving oxidative stress for diabetic peripheral neuropathy patients with metformin treatment TAN Ya-qin, YANG Xiang-ju, LIAO Qing-hui, et al. Department of Endocrinology and Metabolism, Peoples Hospital of Longgang District, Shenzhen 518172, China

【Abstract】Objective To explore improving effect of alpha-lipoic acid in relieving oxidative stress for diabetic peripheral neuropathy patients with metformin treatment. Methods Selected 50 patients with DPN in our hospital and randomly divided them into observation group and control group, 25 cases in each group, both groups receiving metformin for 30 days, observation group was given intravenously ALA. The nerve conduction velocity, serum level of malonaldehyde(MDA) and superoxide dismutase(SOD) were compared before and after treatment in both groups. Results Compared with control group, the MDA was significantly decreased (P<0.01), SOD was significantly increased (P<0.01), the nerve conduction velocity increased significantly in observation group after treatment(P<0.01). Conclusion ALA can effectively improve the clinical symptoms, increase nerve conduction velocity by lightening the oxidative stress of the DPN patients.

【Key words】Diabetic peripheral neuropathy; Alpha lipoic acid; Oxidative stress

糖尿病周围神经病(diabetic peripheral neuropathy, DPN)主要病理学变化为神经纤维的多灶性丢失［1］。其具体机制可能为长期高血糖导致神经微循环血管基底膜增厚, 管腔闭塞, 面积减少, 进而神经缺血缺氧；进一步发展为氧化应激, 多种致氧化因子增多［2］, 使自由基防御减少, 脂质过氧化, 致细胞损伤［3］。α-硫辛酸是强效抗氧化剂, 其主要作用是通过抑制脂质过氧化, 改善血管内皮及神经损伤。研究显示硫辛酸治疗可改善神经脱髓鞘损伤, 改善神经轴突变性, 从而修复损伤的神经, 恢复神经功能［4］。但具体作用机制有待进一步探讨, 因而本文旨在探讨α-硫辛酸在二甲双胍治疗糖尿病周围神经病变中对患者氧化应激的改善作用。现报告如下。

1资料与方法

1. 1一般资料选择50例就治于本院内分泌科的2型糖尿病并周围神经病变患者, 所有患者均符合1999年WHO制定的糖尿病诊断标准；其中男28例, 女22例。平均年龄(45.00±7.63)岁, 男性身高154~195 cm, 平均身高(177.32± 5.59)cm；体重41~89 kg, 平均体重(60.12±5.68)kg；……