前列地尔联合沙格雷酯治疗糖尿病下肢血管病变观察

The combination of alprostadil with sarpogrelate in the treatment for diabetic patients with lower extremity arterial disease

目的观察前列地尔和沙格雷酯治疗糖尿病下肢血管病变的临床疗效。方法 56例2型糖尿病伴下肢血管病变患者随机分为常规治疗组(A=16例)、沙格雷酯组(B=18例)和前列地尔联合沙格雷酯组(C=22例),A组给予改善生活方式,控制血糖、血压、血脂,B组在A组基础上加用沙格雷酯100 mg,3次/d;C组在A组基础上加用前列地尔10μg/d+沙格雷酯100 mg,3次/d;疗程2周,观察患者治疗前后临床症状、足背动脉峰值流速、踝肱血压比(ABI)。结果三组治疗后临床症状均有改善,C组和B组在改善糖尿病下肢血管病变方面具有良好效果(P<0.05),C组在无痛行走距离、最大行走距离、ABI、足背动脉峰值流速的改善方面,较A组差异有统计学意义(P<0.05)。结论前列地尔联合沙格雷酯短期应用能显著改善糖尿病下肢血管病变症状,提高ABI及足背动脉流速。

Objective To observe the therapeutic effect of alprostadil combined with sarpogrelate in the treatment of diabetic patients with lower extremity arterial disease.Methods A total of 56 diabetes patients with lower extremity extremity arterial disease were randomly divided into the conventional therapy group （group A,n =16 ）,the sarpogrelate group （group B,n=18 and the alprostadil combined with sarpogrelate group （group C,n=22）,The patients in Group A received conventional treatment,and Group B received conventional treatment andsarpogrelate with a dose of 100mg （tid）,and Group C received conventional treatment and the combination of alprostadil （10ug/d）with sarpogrelate （100mgTID ）for 2 weeks.The changes in clinical symptoms,the ankle brachial pressure index and the peak flow of dorsalis pedis artery were observed before and after the interventions.Result There were an improvements in clinical symptoms of the three groups after the interventions..There were a significant improvements in diabetic lower extremity vascular disease for patients in group B and C.The distance of pain-free walking and maximal walking,ABI and dorsal artery peak velocity in group C were significantly better than those in group A（P〈0.05）.Conclusion The combination of alprostadil with sarpogrelate showed a significantly improvements in the symptoms of diabetic lower extremity vascular disease,increased ABI and flow velocity of the dorsalis pedis artery.