贝前列腺素钠联合西洛他唑治疗高龄糖尿病患者下肢动脉病变疗效观察

Effects of berapost sodium combined with cilostazol in the treatment of elderly patients with diabetic peripheral artery diseases

目的观察贝前列腺素钠联合西洛他唑对高龄2型糖尿病(T2DM)患者合并下肢动脉病变(PAD)的疗效。方法将48例高龄2型糖尿病合并下肢血管病变患者随机分为2组(每周24例):实验组患者服用贝前列腺素钠20μg每日三次及西洛他唑口服(第一周50 mg bid,第二周开始100 mg bid);对照组仅给予均给予口服西洛他唑(第一周50 mg bid,第二周开始100 mgbid);两组受试者均据病情予降糖、降压、调脂等基础治疗,总疗程24周。观察比较用药前后两组患者症状改善情况及踝肱指数(ABI)、经皮氧分压、足背动脉内径、峰值流速、血流量变化。结果两组患者下肢间隙性跛行、疼痛、麻木感及溃疡倾向均有不同程度改善,实验组较对照组改善更为明显(P<0.05);2组患者治疗后踝肱指数、经皮氧分压、足背动脉内径、峰值流速、血流量较治疗前均有明显改善(P<0.05或0.01),其中实验组前述指标改善较对照组更明显(P<0.05)。结论与单独使用西洛他唑相比,贝前列腺素钠联合西洛他唑治疗高龄2型糖尿病患者下肢动脉病变有效且安全性较好。

Objective To observe the effects of berapost sodium combined with cilostazol in the treatment of elderly patients with diabetic peripheral artery diseases. Methods The 48 elderly diabetic patients with peripheral artery diseases were randomly assigned into combi- nation group with berapost sodium plus cilostazol and comparison group with cilostazol alone. All the patients were given corresponding basic therapies for diabetes, hypertension and other diseases during the 24-weeks study. Main observed parameters were the symptoms in- cluding intermittent claudication, pain, numbness and ulcer tendency in the legs of patients and artery parameters including dorsal artery of foot diameter, peak velocity, blood flow,ankle brachial index and transct^taneous oxygen pressure. Results The intermittent claudica- tion, pain, numbness and ulcer tendency in the legs of patients, were significantly reduced in cilostazol group and combination group with berapost sodium plus cilostazol after treatment （P 〈 0.05 ）, and dorsal artery of foot diameter, peak velocity, blood flow, ankle brachial in- dex and transcutaneous oxygen pressure were significantly improved in both groups too 24 weeks later（P 〈 0.05 or 0.01 ）. At the same time,we found that these symptoms and artery peramemers of combination group with berapost sodium plus cilostazol improved more sig- nificantly than cilostazol group after treatment （P 〈 0.05）. Conclusions The therapeutic efficacy of combination group with berapost so- dium plus cilostazol in treatment of peripheral artery diseases in elderly diabetic patients is significant and safe.