沙格雷酯对糖尿病足患者血清胆红素及炎症因子水平和疗效的影响

Influences of sarpogrelate on serum bilirubin and inflammatory factors levels and its therapeutic effect in patients with diabetic foot

目的探讨常规治疗联合沙格雷酯对糖尿病足患者血清胆红素及炎症因子水平及疗效的影响。方法随机选择2015年1月至2017年12月进行糖尿病足治疗的患者98例作为研究对象。使用随机数字表法分为观察组和对照组,各49例。对照组患者给予常规控制血糖等全身治疗和创面局部治疗;观察组患者在对照组治疗方案基础上给予盐酸沙格雷酯片口服,100 mg,每日3次,两组疗程均6个月。观察患者治疗前后血糖水平、血清胆红素水平、炎症因子水平的变化和临床疗效。结果两组患者治疗前血糖、血清胆红素、炎症因子各指标水平差异无统计学意义(P均>0.05)。治疗后:(1)两组空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)水平较治疗前明显降低(P均<0.05),但组间无统计学差异(P均>0.05);(2)两组总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平水平较治疗前均明显改善(P均<0.05),且观察组治疗后TBIL、IBIL水平明显高于对照组(P均<0.01),但两组DBIL水平无统计学差异(P>0.05);(3)两组血管细胞粘附分子(VCAM)-1、成纤维细胞生长因子(FGF)-2、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6水平较治疗前均明显降低(P均<0.05),且观察组明显低于对照组(P均<0.01)。观察组患者治疗总有效率为91.84%,明显高于对照组的75.51%(P<0.05)。观察组沙格雷酯治疗中未见明显不良反应发生。结论沙格雷酯对糖尿病足患者具有良好的临床疗效,能够明显改善患者血清胆红素水平和炎症因子水平,且有较好的安全性。

Objective To investigate the effects of sarpogrelate on serum levels of bilirubin and inflammatory factors and on the treatment in patients with diabetic foot. Methods A total of 98 patients with diabetic foot treated from January 2015 to December 2017 were randomly selected as the subjects and were randomly divided into observation group and control group (n = 49, each). The patients were given systemic treatment such as routine blood sugar control and local wound treatment in control group,while the oral sarpogrelate tablets were added (100 mg three times daily) in observation group based on the treatment of control group. The treatment course was 6 months in both groups. The changes of blood glucose level, serum bilirubin level, inflammatory factor level and the clinical efficacy were observed before and after treatment in two groups. Results There were no significant differences in the levels of fasting blood glucose, serum bilirubin and inflammatory factors before treatment between two groups( all P〉0. 05 ). After treatment:(1 ) The levels of fasting blood sugar,2 h postprandial blood glucose and haemoglobin Alc( HbAlc) were significantly lower than those before treatment in two groups ( all P <0. 05),but there was no significant difference between two groups ( all P >0. 05 ).(2) The levels of total serum bilirubin(TBIL),direct serum bilirubin( DBIL), indirect serum bilirubin( IBIL) in two groups got significantly improved compared with those before treatment(all P <0. 05),and the levels of TBIL and IBIL in observation group were significantly higher than those in control group ( all P < 0. 01 ), but there was no significant difference in DBIL level between two groups (P > 0. 05 ).( 3 ) The levels of vascular cell adhesion molecule ( VCAM )-1, fibroblast growth factor (FGF)2, tumor necrosis factor(TNF)-α and interleukin( IL)-6 in two groups were significantly lower compared with those before treatment (all P < 0. 05 ) and were significantly lower in observation group than those in control group ( all P < 0. 01 ). The total effective rate in observation group was significantly higher than that in control group (91. 84% vs 75. 51%,P<0. 05 ). There were no obvious adverse reactions in observation group. Conclusion Sarpogrelate has a good clinical effect for patients with diabetic foot and can significantly improve the levels of serum bilirubin and inflammatory factors with better safety.