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目的探讨糖尿病足患者介入治疗加用前列地尔注射液对足部血流的改善作用,为糖尿病足患者的治疗提供临床依据。方法选择北京中医药大学东直门医院2014年6月至2016年6月收治的糖尿病足患者120例,随机分为介入治疗组和对照组,每组60例。两组患者均给予抗感染、控制血糖和血压、改善微循环等常规治疗。介入治疗组患者在常规治疗基础上给予支架成形、球囊扩张等介入手术治疗,术后给予前列地尔注射液静脉滴注治疗4周。观察患者足部溃疡及自觉症状改善情况,评估治疗效果;治疗前后采用彩色多普勒超声检查双侧足背动脉内径及血流变化情况;治疗前后抽取空腹静脉血,检测高敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)、白细胞介素(IL)-6、IL-12水平的变化。应用SPSS 17.0统计学软件进行χ~2检验和t检验。结果介入治疗组治疗总有效率为91.7%,明显高于对照组(73.3%),差异有统计学意义(P<0.05)。两组治疗前足背动脉内径及血流速度差异均无统计学意义(P>0.05),治疗后介入治疗组患者足部血流改善,足背动脉内径明显大于对照组,足背动脉血流速度明显快于对照组,差异均有统计学意义(P<0.05)。两组治疗前hs-CRP、TNF、IL-6、IL-12差异均无统计学意义,治疗后介入治疗组hs-CRP、TNF、IL-6和IL-12水平均明显低于对照组,差异均有统计学意义(P<0.05)。结论介入治疗联合前列地尔治疗糖尿病足效果显著,能有效缓解症状,减轻炎症反应,改善足部血流。
Objective To investigate the effect of perioperative intervention with diabetic alzheimer’s disease on the improvement of foot blood flow in patients with diabetic foot and provide clinical evidence for the treatment of diabetic foot. Methods 120 patients with diabetic foot admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from June 2014 to June 2016 were randomly divided into intervention group and control group, with 60 cases in each group. Two groups of patients were given anti-infection, blood sugar and blood pressure control, improve microcirculation and other conventional treatment. Patients in the intervention group were treated with stenting and balloon dilatation on the basis of routine treatment, and were treated with alprostadil for four weeks after the administration. The foot ulcers and the improvement of symptoms were observed to evaluate the therapeutic effect. The diameter and blood flow of the dorsalis pedis artery were examined by color Doppler ultrasound before and after treatment. Fasting venous blood was collected before and after the treatment, and the high sensitivity C-reactive protein -CRP), tumor necrosis factor (TNF), interleukin (IL) -6, and IL-12. SPSS 17.0 statistical software for χ ~ 2 test and t test. Results The total effective rate of interventional treatment group was 91.7%, which was significantly higher than that of control group (73.3%), the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the diameter of the dorsalis pedis artery and the velocity of blood flow before treatment (P> 0.05). After the intervention, the blood flow in the foot of the intervention group was improved, the diameter of the dorsalis pedis artery was significantly larger than the control group, Significantly faster than the control group, the difference was statistically significant (P <0.05). There were no significant differences in hs-CRP, TNF, IL-6 and IL-12 levels before treatment in both groups. The levels of hs-CRP, TNF, IL-6 and IL-12 in the intervention group after treatment were significantly lower than those in the control group The differences were statistically significant (P <0.05). Conclusion Interventional treatment with alprostadil is effective in treating diabetic foot, which can effectively relieve symptoms, reduce inflammation and improve blood flow in feet.