前列地尔联合介入治疗对老年糖尿病足血清IL-6、IL-12水平的影响

Effect of alprostadil combined with interventional therapy on serum IL-6 and IL-12 levels of elderly patients with diabetic foot

目的 探讨前列地尔联合介入治疗对老年糖尿病足血清白细胞介素-6（IL-6）、白细胞介素-12 （IL-12）水平的影响.方法 选取2010年4月至2012年12月经数字减影血管造影（DSA）确诊为糖尿病足的老年患者90例,随机分为联合治疗组50例和传统治疗组40例,联合治疗组根据患者血管情况采取支架成形术、球囊扩张等介入手术治疗,术后静脉滴注40 μg前列地尔,传统治疗组则给予抗凝、改善静脉微循环等药物治疗.比较两组患者患肢的改善情况及对血清中IL-6、IL-12水平的影响.结果 联合治疗组临床治愈率高达72.00％,明显高于传统治疗组的47.50％,差异有统计学意义（P＜ 0.05）.治疗后,联合治疗组左、右足背动脉管径及血流量为（2.31±0.71）mm、（2.28±0.69）mm和（36.21±10.58）cm/s、（36.78±11.12）cm/s,均明显高于传统治疗组的（1.72±0.69）mm、（1.70±0.72）mm和（28.32±10.28） cm/s、（28.00±10.58） cm/s,差异有统计学意义（P＜0.05）.联合治疗组治疗后血清中IL-6、IL-12的下降值为（53.20±]1.80） mg/L和（35.25±9.18） mg/L,显著高于传统治疗组的（31.15±15.38） mg/L和（26.10±10.12） mg/L （P＜0.05）.结论 前列地尔联合介入治疗明显提高老年糖尿病足患者的治愈机率,改善足背动脉管径及其血流量,同时减轻患者患肢的炎症反应,使患者机体内环境保持稳定.

Objective To discuss the effect of alprostadil combined with interventional therapy on serum IL-6 and IL-12 levels of elderly diabetic foot in the treatment.Methods 90 elderly patients with diabetic foot diagnosed by digital subtraction angiography （DSA） from April 2010 to December 2012 were randomly selected and divided into combination group （50 cases） and conventional treatment group （40 cases）.Combination group received stent angioplasty or balloon expansion,and was given 40 μ g approximated by intravenous drip after surgery.Conventional treatment group received anticoagulation,improved intravenous microcirculation and other drugs treatments.The we compared limb improvement and the serum IL-6,IL-12 levels in two groups.Results The clinical cure rate in the combination group reached to 72.00％,which was significantly higher than that in the conventional treatment group （47.50％） （P ＜ 0.05）.The diameter and blood flow of dorsalis pedis artery （left and right） in combination group were （2.31 ± 0.71） mm,（2.28 ± 0.69）mm and （36.21 ± 10.58） cm/s,（36.78 ± 11.12）cm/s,significantly higher than that in conventional treatment group [（1.72 ± 0.69）mm,（1.70 ± 0.72） mm and （28.32 ± 10.28） cm/s,（28.00± 10.58） cm/s].The differences were statistically significant （P ＜ 0.05）.The reduction on serum IL-6,IL-12 in combination group were （53.20 ± 11.80） mg/L and （35.25 ± 9.18） mg/L respectively,which were significantly higher than those of conventional treatment group [（31.15 ± 15.38） mg/L and （26.10 ± 10.12） mg/L] （P ＜ 0.05）.Conclusion The treatment of unprofitable combined with interventional therapy can obviously improve cure rate,pedis artery diameter and blood flow in elderly patients with diabetic foot.At the same time,the treatment can alleviate inflammatory reaction of the limb and make the body＇s internal environment stable.