目的 探讨二甲双胍和维生素B12对糖尿病患者神经系统的影响。方法 选取52例糖尿病患者作为研究对象，其中长 期应用二甲双胍者30例(观察组)，未长期应用二甲双胍者22例(对照组)，比较两组患者的维生素B12水平及神经肌 电图变化。结果 观察组的维生素B12和HDL-C水平都明显低于对照组(P<0.05)，HbAlC、TG、TC、LDL-C水平与对照 组比较无明显差异(P>0.05)。观察组的神经肌电图正常率为23.33%，明显低于对照组的50.00%，震动阈值检测正常 率为36.67%，明显低于对照组的59.09%，P<0.05。两组的足底轻触觉检查正常率分别为70.00%和72.73%，组间比较 无明显差异(P>0.05)。结论 二甲双胍治疗糖尿病，可能引起维生素B12水平降低，引发医源性神经系统损伤，临床 在应用二甲双胍治疗糖尿病时，应定期进行维生素B12水平监测，并及时补充维生素B12。

Objective To investigate the effects of metformin and vitamin B12 of the nervous system in diabetic patients. Methods 52 cases of diabetic patients were selected as research subjects, which were 30 cases of long-term use of metformin (study group), no long-term use of metformin in 22 patients (control group), vitamin B12 levels and EMG changes in two groups were compared. Results Vitamin B12 and HDL-C levels in the observation group were significantly lower than the control group (P<0.05), HbAlC, TG, TC, no significant difference (P LDL-C levels were> 0.05). EMG normal observation group was 23.33%, significantly lower than the 50.00% in the control group, normal vibration threshold detection was 36.67%, significantly lower than the 59.09% in the control group, P<0.05. Plantar light touch to check the normal rate in both groups was 70.00% and 72.73% respectively, no significant difference between groups (P>0.05). Conclusion Metformin treatment of diabetes, may lead to reduced levels of vitamin B12, causing iatrogenic nervous system damage, metformin treatment in the application of clinical diabetes, vitamin B12 levels should be regularly monitored and replenish vitamin B12.