低分子肝素治疗糖尿病足的近期疗效观察

Obsoervation of Low Molecular Weight Heparin in Treatment of Diabetic Foot

目的观察低分子肝素(LWMH)治疗糖尿病足的临床疗效。方法将54例糖尿病足患者随机分为观察组和对照组。两组均予胰岛素常规降糖,抗感染治疗和常规换药处理。观察组加用LWMH5000 IU皮下注射,每12h 1次,共15天。分别观察两组治疗前后血浆内皮素(ET)、血栓素(TXB2)、血液流变学、踝肱指数异常度、溃疡愈合情况及纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)的变化。结果观察组在血浆ET、TXB2变化、血液流变学指标的改善和溃疡愈合情况方面优于对照组(P<0.05或P<0.01)。两组治疗前后FIB、PT、APTT变化不明显(P>0.05),无出血等并发症。结论LWMH治疗糖尿病足有效且安全性好。

Objective To observe the effect of low molecular weight heparin（LMWH） in treatment of diabetic foot. Methods Fifty-four patients were divided into test group and control group randomly. Both two groups were given routine therapy including mediating blood glucose with Insulin,anti-infection and changing dressings, while the test group were givon LMWH 5000IU once datly every 12 hours for 15 days besides the routine treatment. Then the endothelin（ET） , thromboxaneB2 （TXB2） , hemorheology, ankle -brachial index （ABI）, ulcer healing, fibrinogen（FIB）, prothrombin time （PT） and avtivated parital thromboplastin time（APTT） were observed. Results Compared to that of before treatment, there are ET. TXB2 ,hemorheology and better ulcer heals after treatment. The imorovement in test group patients was superior to that of control group （P〈0.05）. There were no significant differences between FIB, PT and APTT（P〉0.05） after treatment in two groups. No hemorrhage and other complications oecurred. Conclusion LMWH is effective and safe for treatment of diabetic foot.