CAJ | 학술논문

目的：探讨前列地尔联合血栓通治疗2型糖尿病合并下肢血管性病变的临床疗效。方法选取2009年1月—2012年5月攀枝花市第二人民医院收治的2型糖尿病合并双下肢血管病变患者80例，随机分为观察组与对照组，各40例。对照组予以前列地尔治疗，观察组患者在对照组基础上加用血栓通治疗。观察两组患者血清总胆固醇（ TC）、三酰甘油（ TG）、超敏C反应蛋白（ hs-CRP）水平、全血黏度、无痛行走距离、最大行走距离、下肢疼痛积分、踝肱指数（ ABI ）、股动脉、腘动脉、胫后动脉、足背动脉内径及血流量。结果治疗前两组患者 TG、TC、hs-CRP水平和全血黏度比较，差异无统计学意义（ P>0.05），治疗后观察组患者TG、TC、hs-CRP水平和全血黏度低于对照组，差异有统计学意义（ P<0.05）；治疗前两组患者无痛行走距离、最大行走距离、下肢疼痛积分及ABI比较，差异无统计学意义（ P>0.05），观察组患者治疗前后无痛行走距离和最大行走距离差值大于对照组（ P<0.05），治疗后观察组患者ABI 高于对照组（ P <0.05），两组患者下肢疼痛积分比较，差异无统计学意义（ P >0.05）；治疗前两组患者股动脉、腘动脉、胫后动脉、足背动脉内径及血流量比较，差异无统计学意义（ P>0.05），观察组患者治疗前后股动脉、腘动脉、胫后动脉、足背动脉内径及血流量差值大于对照组（ P<0.05）。结论前列地尔联合血栓通治疗2型糖尿病合并下肢血管性病变的临床疗效显著，可改善患者预后，减轻患者疼痛感。
목적：탐토전렬지이연합혈전통치료2형당뇨병합병하지혈관성병변적림상료효。방법선취2009년1월—2012년5월반지화시제이인민의원수치적2형당뇨병합병쌍하지혈관병변환자80례，수궤분위관찰조여대조조，각40례。대조조여이전렬지이치료，관찰조환자재대조조기출상가용혈전통치료。관찰량조환자혈청총담고순（ TC）、삼선감유（ TG）、초민C반응단백（ hs-CRP）수평、전혈점도、무통행주거리、최대행주거리、하지동통적분、과굉지수（ ABI ）、고동맥、객동맥、경후동맥、족배동맥내경급혈류량。결과치료전량조환자 TG、TC、hs-CRP수평화전혈점도비교，차이무통계학의의（ P>0.05），치료후관찰조환자TG、TC、hs-CRP수평화전혈점도저우대조조，차이유통계학의의（ P<0.05）；치료전량조환자무통행주거리、최대행주거리、하지동통적분급ABI비교，차이무통계학의의（ P>0.05），관찰조환자치료전후무통행주거리화최대행주거리차치대우대조조（ P<0.05），치료후관찰조환자ABI 고우대조조（ P <0.05），량조환자하지동통적분비교，차이무통계학의의（ P >0.05）；치료전량조환자고동맥、객동맥、경후동맥、족배동맥내경급혈류량비교，차이무통계학의의（ P>0.05），관찰조환자치료전후고동맥、객동맥、경후동맥、족배동맥내경급혈류량차치대우대조조（ P<0.05）。결론전렬지이연합혈전통치료2형당뇨병합병하지혈관성병변적림상료효현저，가개선환자예후，감경환자동통감。
Objective To explore the clinical effect of alprostadil combined with thrombus clear in treatment of type 2 diabetes mellitus with vascular disease of the lower extremity. Methods A total of 80 patients with type 2 diabetes mellitus with vascular disease of the lower extremity were selected in the Second People's Hospital of Panzhihua from January 2009 to May 2012,they were randomly divided into control group and observation group,each of 40 cases. Control group was treated with alprostadil,observation group was treated with alprostadil combined with thrombus clear. Ttotal cholesterol( TC),triglyceride ( TG)and high-sensitivity c-reactive protein( hs-CRP)level,blood viscosity,painless walking distance,maximum walking distance,lower extremity pain integral,ankle-brachial index( ABI),femoral artery,popliteal artery,posterior tibial artery, dorsal artery of foot diameter and blood flow of the two groups were observed and compared. Results Before treatment,TG, TC,hs-CRP level and blood viscosity showed no significant differences between the two groups(P>0. 05),TG,TC,hs-CRP level and blood viscosity of observation group was lower than that of control group after treatment(P<0. 05);before treatment, painless walking distance,maximum walking distance,lower extremity pain integral and ABI showed no significant differences between the two groups(P>0. 05),before and after treatment painless walking distance and maximum walking distance differ-ence value of observation group was greater than that of control group( P<0. 05),ABI of observation group was higher than that of control group after treatment(P <0. 05),lower extremity pain integral showed no significant differences between the two groups(P>0. 05);before treatment,femoral artery,popliteal artery,posterior tibial artery,dorsal artery of foot diameter and blood flow showed no significant differences between the two groups(P>0. 05),before and after treatment femoral artery, popliteal artery,posterior tibial artery,dorsal artery of foot diameter and blood flow difference value of observation group was greater than that of control group( P <0. 05).Conclusion Alprostadil combined with thrombus clear has notable curative effect in the treatment of type 2 diabetes mellitus with vascular disease of the lower extremity ,can improve patients' prognosis and reduce pain.