摘要
目的 系统评价2型糖尿病患者周围神经病变的影响因素.方法 计算机检索PubMed、Cochrane Li-brary、Embase、Web of Science、中国知网、万方数据知识服务平台、维普数据库及中国生物医学数据库中关于2型糖尿病患者周围神经病变影响因素的研究,检索时限为建库至2023年1月1日.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.4软件进行统计学分析.结果 共纳入25篇文献.Meta分析结果显示:年龄[MD=5.45,95％CI(3.96,6.94),P＜0.001]、糖尿病病程[MD=3.55,95％CI(1.84,5.26),P＜0.001]、糖化血红蛋白[MD=1.20,95％CI(0.85,1.55),P＜0.001]、空腹血糖[MD=1.93,95％CI(1.09,2.77),P＜0.001]、餐后 2 h 血糖[MD=3.24,95％CI(2.27,4.20),P＜0.001]、收缩压[MD=5.81,95％CI(4.23,7.40),P＜0.001]、血肌酐[MD=16.47,95％CI(15.66,17.29),P＜0.001]、使用胰岛素[OR=2.54,95％CI(1.83,3.54),P＜0.001]、糖尿病视网膜病变[OR=3.25,95％CI(2.69,3.93),P＜0.001]、糖尿病肾病[OR=2.81,95％CI(2.18,3.62),P＜0.001]及脉搏波传导速度[MD=1.32,95％CI(0.95,1.70),P＜0.001]是2型糖尿病患者周围神经病变的影响因素.结论 2型糖尿病患者周围神经病变的影响因素较多,医护人员应针对患者个体情况采取预见性干预措施,以降低糖尿病周围神经病变的发生风险.
Abstract
Objective To analyze the influencing factors of peripheral neuropathy among type 2 diabetic patients.Methods Studies on influencing factors of peripheral neuropathy among type 2 diabetic patients were searched in PubMed,the Cochrane Library,Embase,Web of Science,CBM,CNKI,WanFang and VIP databases,with the time setting from inception to 1st January 2023.Two reviewers screened the literature independently,extracted information and assessed the risk of bias of the included studies.Results A total of 25 studies were included.Meta analysis results showed that the main influencing factors of peripheral neuropathy in type 2 diabetes patients included age[MD=5.45,95％CI(3.96,6.94),P＜0.001],course of disease[MD=3.55,95％CI(1.84,5.26),P＜0.001],HbA1c[MD=1.20,95％CI(0.85,1.55),P＜0.001],fasting blood glucose[MD=1.93,95％CI(1.09,2.77),P＜0.001],2 h postprandial blood glucose[MD=3.24,95％CI(2.27,4.20),P＜0.001],systolic blood pressure[MD=5.81,95％CI(4.23,7.40),P＜0.001],serum creatinine[MD=16.47,95％CI(15.66,17.29),P＜0.001],insulin use[OR=2.54,95％CI(1.83,3.54),P＜0.001],diabetic retinopathy[OR=3.25,95％CI(2.69,3.93),P＜0.001],diabetic nephropathy[OR=2.81,95％CI(2.18,3.62),P＜0.001]and pulse wave velocity(PWV)[MD=1.32,95％CI(0.95,1.70),P＜0.001].Conclusion There are many factors affecting peripheral neuropathy in patients with type 2 diabetes,and medical staff should take predictive intervention measures according to individual conditions of patients to reduce the risk of diabetic peripheral neuropathy.
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