摘要
目的观察结核药物异烟肼对肺结核合并糖尿病周围神经病变患者神经传导速度的影响。方法选择我院住院患者按病例对照研究分组,分为单纯初治非耐药肺结核(simple initial treatment of non drug-resistant pulmonary tuberculosis,TB)组、2型糖尿病周围神经病变(type 2 diabetes peripheral neuropathy,DPN)组、2型糖尿病周围神经病变合并初治非耐药肺结核(type 2 diabetic peripheral neuropathy combined with initial treatment of non-drug-resistant pulmonary tuberculosis,DPNTB)组,每组39例。根据患者具体情况,给予患者合适的降糖方案,血糖控制均达标。肺结核病例均为初治继发性非耐药肺结核,均采用一线标准化强化治疗方案HRZE即:异烟肼(Isoniazid,H)0.3 g/次,1次/d;利福平(Rifampicin,R)0.45 g/次,1次/d;吡嗪酰胺(Pyrazinamide,Z)0.5 g/次,3次/d;乙胺丁醇(Ethambutol,E)0.75 g/次,1次/d,均口服,疗程2个月。比较3组治疗前后下肢腓浅神经和腓肠神经的感觉神经传导速度,下肢腓深神经、腓浅神经、腓总神经、胫神经及股神经的运动神经传导速度。结果治疗后,TB组和DPNTB组下肢腓浅神经及腓肠神经感觉神经传导速度慢于治疗前,DPNTB组下肢腓浅神经及腓肠神经感觉神经传导速度慢于TB组和DNP组,差异有统计学意义(P<0.05)。治疗前后各组间下肢腓深神经、腓浅神经、腓总神经、胫神经、股神经运动神经传导速度差异无统计学意义(P>0.05)。结论异烟肼可导致肺结核及肺结核合并糖尿病周围神经病变患者的下肢感觉神经传导速度减慢;异烟肼使合并糖尿病周围神经病变的肺结核患者,下肢感觉神经传导速度更慢。异烟肼而对下肢运动神经影响不显著。
Objective To observe the effect of anti-tuberculosis drug isoniazid on nerve conduction velocity in patients with pulmonary tuberculosis complicated with diabetic peripheral neuropathy(DPN).Methods Patients admitted to our hospital were selected and grouped according to the case-control study.The patients were divided into simple initial treatment of non-drug-resistant pulmonary tuberculosis(TB)group(n=39),type 2 diabetic peripheral neuropathy(T2DPN)group(n=39),T2DPN combined with initial treatment of non-drug-resistant pulmonary tuberculosis(DPNTB)group(n=39).According to the specific conditions of patients,appropriate hypoglycemic regimens were given to patients,and the target blood glucose level was reached.All cases were newly diagnosed with secondary non-drug resistant pulmonary tuberculosis,and all received the first-line standardized intensive treatment regimen HRZE:Isoniazid(H)0.3 g/time,once daily;Rifampicin(R)0.45 g/time,once daily;Pyrazinamide(Z)0.5 g/time,3 times/day;Ethambutol(E)0.75 g/time,once daily;They were all taken orally for 2 months.The sensory nerve conduction velocity of superficial peroneal nerve and sural nerve,and the motor nerve conduction velocity of deep peroneal nerve,superficial peroneal nerve,common peroneal nerve,tibial nerve and femoral nerve were compared among the three groups before and after treatment.Results After treatment,the sensory nerve conduction velocity of superficial peroneal nerve and sural nerve in the lower limbs of TB group and DPNTB group was significantly slower than that before treatment,and the sensory nerve conduction velocity of superficial peroneal nerve and sural nerve in DPNTB group was slower than that in TB group and DNP group,showing significant difference(P<0.05).There was no significant change in motor nerve conduction velocity of deep peroneal nerve,superficial peroneal nerve,common peroneal nerve,tibial nerve and femoral nerve among the three groups before and after treatment(P>0.05).Conclusion Isoniazid can cause sensory nerve conduction velocity to slow down in patients with pulmonary tuberculosis and DPN.especially in the lower limbs of pulmonary tuberculosis patients with DPN.Isoniazid had no significant effect on the motor nerves of the lower limbs.
作者
冯彦景
殷智晔
李艳君
王显雷
侯永华
于丽微
FENG Yan-jing;YIN Zhi-ye;LI Yan-jun;WANG Xian-lei;HOU Yong-Hua;YU Li-wei(Department of Endocrinology,Hebei Chest Hospital,Shijiazhuang 050047,China;Department of Respiratory Medicine,Hebei Chest Hospital,Shijiazhuang 050047,China;Department of Tuberculosis,Hebei Chest Hospital,Shijiazhuang 050047,China)
出处
《河北医科大学学报》
CAS
2024年第4期378-382,共5页
Journal of Hebei Medical University
基金
河北省医学科学研究课题计划(20211241)。
关键词
结核
肺
糖尿病神经病变
神经传导
异烟肼
tuberculosis,pulmonary
diabetic neuropathies
neural conduction
isoniazid
