中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2013年
6期
328-331
,共4页
顾洪斌%解华杰%王志鸿%杨帆%盛磊
顧洪斌%解華傑%王誌鴻%楊帆%盛磊
고홍빈%해화걸%왕지홍%양범%성뢰
糖尿病,2型%下肢动脉硬化闭塞症%血栓%重症肢体缺血%血管腔内介入治疗
糖尿病,2型%下肢動脈硬化閉塞癥%血栓%重癥肢體缺血%血管腔內介入治療
당뇨병,2형%하지동맥경화폐새증%혈전%중증지체결혈%혈관강내개입치료
Diabetes mellitus,type 2%Lower extremity arteriosclerosis obliterans%Thrombosis%Critical limb ischemia%Endovascular intervention therapy
目的 回顾性分析2型糖尿病合并下肢动脉血栓形成患者的临床特点与溶栓并腔内治疗的效果.方法 选取2008年1月至2012年12月在解放军第三○六医院采用腔内介入治疗的糖尿病合并急性下肢动脉血栓形成患者46例为研究对象,其中男8例,女38例,平均年龄(68±16)岁,急性下肢缺血病程平均(7±4)d,平均糖尿病病程(8±6)年.根据下肢动脉血栓部位与腹股沟韧带关系,将患者分为中央型(8例)、周围型(22例)及混合型(16例)共3组,分析患者相关临床资料,比较组间导管溶栓治疗的差异,并观察治疗前后踝肱指数(ABI)的变化.多组间比较采用单因素方差分析,两两比较采用Student-Newman-Keuls检验.结果 周围型血栓患者导管溶栓尿激酶用量明显小于中央型和混合型患者[分别为(280±40)、(350±60)、(360±40)万U,F=184.47,P＜0.05],周围型血栓患者溶栓持续时间明显小于中央型和混合型患者[分别为(52±12)、(76±20)、(72±14)h,F=1203.39,P＜0.05]；而中央型与混合型患者之间上述指标均无明显差异(均P＞0.05).所有患者溶栓后的残余狭窄均予以腔内介入治疗.治疗完成后踝肱指数(ABI)较术前明显升高[分别为(0.31±0.15)、(0.95±0.31),t=15.312,P＜0.05].结论 对于2型糖尿病合并急性下肢动脉血栓形成患者,血栓范围越广,导管溶栓药量越大,溶栓周期越长；导管溶栓结合腔内治疗的疗效满意.
目的 迴顧性分析2型糖尿病閤併下肢動脈血栓形成患者的臨床特點與溶栓併腔內治療的效果.方法 選取2008年1月至2012年12月在解放軍第三○六醫院採用腔內介入治療的糖尿病閤併急性下肢動脈血栓形成患者46例為研究對象,其中男8例,女38例,平均年齡(68±16)歲,急性下肢缺血病程平均(7±4)d,平均糖尿病病程(8±6)年.根據下肢動脈血栓部位與腹股溝韌帶關繫,將患者分為中央型(8例)、週圍型(22例)及混閤型(16例)共3組,分析患者相關臨床資料,比較組間導管溶栓治療的差異,併觀察治療前後踝肱指數(ABI)的變化.多組間比較採用單因素方差分析,兩兩比較採用Student-Newman-Keuls檢驗.結果 週圍型血栓患者導管溶栓尿激酶用量明顯小于中央型和混閤型患者[分彆為(280±40)、(350±60)、(360±40)萬U,F=184.47,P＜0.05],週圍型血栓患者溶栓持續時間明顯小于中央型和混閤型患者[分彆為(52±12)、(76±20)、(72±14)h,F=1203.39,P＜0.05]；而中央型與混閤型患者之間上述指標均無明顯差異(均P＞0.05).所有患者溶栓後的殘餘狹窄均予以腔內介入治療.治療完成後踝肱指數(ABI)較術前明顯升高[分彆為(0.31±0.15)、(0.95±0.31),t=15.312,P＜0.05].結論 對于2型糖尿病閤併急性下肢動脈血栓形成患者,血栓範圍越廣,導管溶栓藥量越大,溶栓週期越長；導管溶栓結閤腔內治療的療效滿意.
목적 회고성분석2형당뇨병합병하지동맥혈전형성환자적림상특점여용전병강내치료적효과.방법 선취2008년1월지2012년12월재해방군제삼○륙의원채용강내개입치료적당뇨병합병급성하지동맥혈전형성환자46례위연구대상,기중남8례,녀38례,평균년령(68±16)세,급성하지결혈병정평균(7±4)d,평균당뇨병병정(8±6)년.근거하지동맥혈전부위여복고구인대관계,장환자분위중앙형(8례)、주위형(22례)급혼합형(16례)공3조,분석환자상관림상자료,비교조간도관용전치료적차이,병관찰치료전후과굉지수(ABI)적변화.다조간비교채용단인소방차분석,량량비교채용Student-Newman-Keuls검험.결과 주위형혈전환자도관용전뇨격매용량명현소우중앙형화혼합형환자[분별위(280±40)、(350±60)、(360±40)만U,F=184.47,P＜0.05],주위형혈전환자용전지속시간명현소우중앙형화혼합형환자[분별위(52±12)、(76±20)、(72±14)h,F=1203.39,P＜0.05]；이중앙형여혼합형환자지간상술지표균무명현차이(균P＞0.05).소유환자용전후적잔여협착균여이강내개입치료.치료완성후과굉지수(ABI)교술전명현승고[분별위(0.31±0.15)、(0.95±0.31),t=15.312,P＜0.05].결론 대우2형당뇨병합병급성하지동맥혈전형성환자,혈전범위월엄,도관용전약량월대,용전주기월장；도관용전결합강내치료적료효만의.
Objective To investigate the clinical features of the lower extremity artery thrombosis in the type 2 diabetes patients and to evaluate the effect of the catheter directed thrombolysis combined with endovascular intervention.Method A total of 46 type 2 diabetes patients with acute lower extremity artery thrombosis who were performed the catheter directed thrombolysis and the endovascular intervention in the PLA 306th Hospital during the period from January,2008 to December,2012 were enrolled in the study.The subjects consisted of 8 males and 38 females aged (68 ± 16) years old with the diabetes duration of (8 ±6)years and the acute limb ischemia duration of (7 ± 4) days.The subjects were divided into three groups according to the location of the lower extremity artery thrombosis relative to the inguinal ligament.,which were the central group (8 cases),the peripheral group (22 cases) and the mixed group (16 cases).The treatment process of the catheter directed thrombolysis was compared among the groups and the anke brachial index (ABI) was monitored before and after the treatment.Single factor variance analysis was used for multi-group comparison,and Student-Newman-Keuls test was used for comparison between two groups.Results The needed dosage of urokinase was less in the peripheral group than those in the central and mixed groups ((280 ± 40),(350 ± 60),(360 ± 40) × 104 U,respectively,F =184.47,P ＜ 0.05).The required time for thrombolysis treatment was also less in the peripheral group than in the central and mixed groups ((52 ± 12),(76 ± 20),(72 ± 14) h,respectively,F =1203.39,P ＜ 0.05).Between the central group and the mixed group,no statistical difference was observed in the needed urokinase dosage or the required thrombolysis time (P ＞ 0.05).After the catheter directed thrombolysis,all residual stenoses were treated with the endovascular intervention.The ABI was significantly increased by the endovascular intervention from (0.31 ± 0.15) to (0.95 ± 0.31).Conclusions More extensive the thrombosis,much higher dosage of catheter thrombolytic drug and longer treatment time are required.The catheter directed thrombolysis combined with endovascular intervention is a safe and effective treatment to acute lower extremity artery thrombosis in type 2 diabetes patients.
