前列地尔治疗老年糖尿病下肢血管病变的临床分析

Clinical Analysis of Alprostadil in the Treatment of Diabetic Lower Extremity Vascular Disease in the Elderly

目的分析前列地尔治疗老年糖尿病下肢血管病变的疗效和安全性,为治疗该病症提供方法。方法选择2019年1月-2019年12月于河北北方学院附属第一医院收治的老年糖尿病下肢血管病变患者150例,根据数字表法随机分为观察组(n=80)和对照组(n=70)。对照组采取常规治疗,观察组在此基础上加用前列地尔治疗。评估并比较2组患者治疗前后临床症状积分、踝肱比值、细胞因子及氧化应激指标值变化,同时比较2组治疗效果和不良反应情况。结果观察组治疗后临床症状积分明显低于治疗前,而踝肱指数明显高于治疗前,差异均有统计学意义(P<0.05);对照组治疗前后临床症状积分和踝肱指数差异均无统计学意义(P>0.05)。治疗后观察组临床症状积分明显低于对照组,而踝肱指数明显高于对照组,差异均有统计学意义(P<0.05)。2组治疗前后以及2组治疗后白细胞介素-6、白细胞介素-10和肿瘤坏死因子-水平差异均无统计学意义(P>0.05)。观察组治疗后氧化低密度脂蛋白和8异前列腺素F2水平明显低于治疗前,而超氧化物歧化酶水平明显高于治疗前,差异均有统计学意义(P<0.05);对照组治疗前后氧化低密度脂蛋白、8异前列腺素F2和超氧化物歧化酶水平差异均无统计学意义(P>0.05)。治疗后观察组氧化低密度脂蛋白和8异前列腺素F2水平显著低于对照组,而超氧化物歧化酶水平显著高于对照组,差异均有统计学意义(P<0.05)。观察组治疗总有效率明显高于对照组(P<0.05)。2组患者治疗不良反应总发生率差异无统计学意义(P>0.05)。结论前列地尔能够有效缓解老年糖尿病下肢血管病变患者临床症状,改善下肢血流,降低氧化应激反应,治疗效果显著,安全性较高,但其对炎性细胞因子无明显影响。

Objective To analyze the efficacy and safety of alprostadil in the treatment of diabetic lower extremity vascular disease in the elderly,and to provide a method for the treatment of this disease.Methods 150 patients with diabetic lower extremity vascular disease admitted to our hospital were randomly divided into two groups:control group(70 cases)and observation group(80 cases).The control group was treated with routine therapy,and the observation group was treated with alprostadil on the basis of the control group.The changes of clinical symptom score,ankle brachial ratio,cytokines and oxidative stress indexes were evaluated and compared before and after the treatment,and the therapeutic effect and adverse reactions were compared between the two groups.Results The clinical symptom score in the observation group was significantly lower than that before treatment,while the ankle brachial ratio was significantly higher than that before the treatment(P<0.05);There was no significant difference of clinical symptom score and ankle brachial ratio before and after treatment of the control group(P>0.05);after the treatment,the clinical symptom score of the observation group was significantly lower than that of the control group,while the ankle brachial ratio was significantly higher than that of the control group(P<0.05).There was no significant difference in the levels of interleukin-6,interleukin-10 and tumor necrosis factor-between the two groups before and after treatment(P>0.05).The levels of oxidized low-density lipoprotein and 8-isoprostaglandin F2 of the observation group after the treatment were significantly lower than those before treatment,while the levels of superoxide dismutase were significantly higher than that before treatment(P<0.05);There was no significant difference in the levels of oxidized low-density lipoprotein,8-isoprostaglandin F2 and superoxide dismutase of the control group before and after treatment(P>0.05);After the treatment,the levels of oxidized low-density lipoprotein and 8-isoprostaglandin F2 of the observation group were significantly lower than those of the control group,while the level of superoxide dismutase were significantly higher than that of the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Alprostadil can effectively relieve the clinical symptoms,improve the blood flow of the lower limbs,reduce the oxidative stress response of the elderly patients with diabetic lower extremity vascular disease.The therapeutic effect is significant and the safety is high,but it has no significant effect on inflammatory cytokines.