前列腺素E1脂微球载体制剂的疗程与糖尿病足血运改善的相关性
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【摘要】 目的：分析前列腺素e1脂微球载体制剂（前列地尔注射液，凯时）疗程与糖尿病足病患者血运改善程度的相关性。方法：选择80例糖尿病足溃疡合并双下肢动脉硬化闭塞症患者，以治疗前的踝肱指数（ABI）值分组，分为轻度、中度和重度缺血组。凯时静脉输入3周为一个疗程，间歇1周后开始第2个疗程，连续3个疗程，每个疗程后均测量ABI数值，3个疗程结束后评估患者ABI变化。结果：对于下肢轻度和中度缺血的患者，凯时的疗程数与血运改善程度呈正相关，但是在重度缺血的患者，凯时的疗效未能体现。结论：凯时多疗程治疗可以显著改善轻、中度血运障碍的糖尿病足患者下肢血供。
【关键词】 糖尿病足； 下肢动脉硬化闭塞症； 凯时； 多疗程； 踝肱指数
The Relation between Courses of Lipo—PGE1 Treatment and Blood—supply Improvement in Diabetic Foot Patients/YANG Wei，WANG Peng—hua，CHU Yue—jie，et al.// Medical Innovation of China，2012，9（29）：003—005
【Abstract】 Objective：To evaluate effects of different courses of alprostandil in treatment of diabetic foot ulcers with various degrees of peripheral vascular diseases （PVD）. Method：Eighty patients，who were hospitalized in the Tianjin Metabolic Diseases Hospital from September 2010 to September 2011，suffered with diabetic foot ulcers and peripheral vascular diseases were given alprostandil injection.The patients were divided into three groups as mild，moderate and severe degrees according to the values of ankle brachial index （ABI）.Three—week was termed as one course，and the next course was started by interval of one week.Three courses were administered totally. The ABI values of the patients before and after the alprostandil treatments were monitored and analyzed. Result：The effects of three courses of alprostandil treatment were different to various degrees of PVD.Multiple courses of alprostandil treatments increased ABI values in higher levels compared to single courses in the mild and moderate PAD patients （P
【Key words】 Diabetic foot； Peripheral vascular diseases； Alprostadil injection； Multiple courses； Ankle brachial index
First—author’s address：Metabolic Diseases Hospital Affliated to Tianjin Medical University，Tianjin 300070，China
doi：10.3969/j.issn.1674—4985.2012.29.002
糖尿病足是在糖尿病基础上由于合并神经病变及各种不同程度下肢血管病变而导致足部感染、溃疡形成和（或）深部组织的破坏，为糖尿病慢性并发症之一，是糖尿病患者致残、致死的主要原因之一[1]。高达85%的糖尿病相关截肢是由足溃疡引起的，使患者承受了巨大的创伤和经济压力[2]，而造成截肢最主要的原因是周围血管病变（PVD，下肢动脉硬化闭塞症是其主要表现形式之一）。有临床研究显示应用凯时可以有效地改善下肢血供[3]。但凯时疗程在临床实践中因地而异，其疗效在不同缺血程度患者中的报道比较少见。本试验通过比较80例合并不同程度PVD的糖尿病足患者应用凯时治疗前以及不同疗程治疗后踝肱指数（ABI）数值的变化来评估其改善血运的疗效。
1 资料与方法