摘要目的 比较西洛他唑联合胰激肽原酶与单用西洛他唑治疗2型糖尿病下肢血管病变(LEADDP)的临床疗效.方法 将LEADDP患者106例随机分为西洛他唑对照组53例,联合胰激肽原酶治疗组53例;治疗前后给予降糖药物使血糖保持稳定;对照组口服西洛他唑片100 mg,2次/d,治疗组在应用西洛他唑的同时口服胰激肽原酶肠溶片120单位,3次/d,空腹服用,共3个月.比较2组治疗后临床症状、踝/肱指数(ABI)、血液流变学、甲襞微循环、动脉内中膜厚度(IMT)及斑块厚度等.结果 2组患者治疗后临床症状好转、ABI较治疗前增加(P<0.05),联合用药组增加更明显,与对照组治疗后比较有显著性差异(P<0.05);右足背动脉、左右胫后动脉IMT较治疗前有明显改善(P<0.05),斑块厚度较治疗前减少(P<0.01);甲襞微循环加权积分值较治疗前改善差异有统计学意义(P<0.01);且治疗前后差值比对照组亦有统计学意义(P<0.05).结论 西洛他唑与胰激肽原酶联合用药效果优于单用西洛他唑治疗PDA患者.

abstractsObjective To compare clinical effects between cilostazol(CLT)alone and cilostazol combined with pancreatic kininogenase(PK)on lower extremity arterial disease in diabetic patient(LEADDP).Methods Patients with LEADDP were randomly divided into 2 groups:single medication group or the control group(53 cases)and combination group or the treatment group(53 cases).Sugar-reducing medicines were given before and after treatment to keep a steady blood glucose level.The control group took CLT orally 100 mg each time,twice a day.Besides receiving the same dose of CLT,the treatment group took 120 tablet of PK on an empty stomach,three times a day,with the duration of 3 months.Clinical symptoms,ankle/brachial index(ABI),blood rheology,nailfold microcirculation,intimal medial thickness(IMT)and plaque thickness were compared between the 2 groups after treatment.Results Symptoms in both groups improved after treatment.ABI was elevated significantly compared to that before treatment(P<0.05)and the change was more obvious in combination group.The difference of ABI after treatment between the 2 groups had statistical significance(P<0.05).IMT of the right foot dorsal artery,and left and right posterior tibial artery increased significantly compared to that before treatment(P<0.05).Plaque thickness decreased compared to that before treatment(P<0.01)and the difference between before and after treatment in combination group was significantly greater than that in single medication group(P<0.05).Conclusion Cilostazol combined with pancreatic kininogenase has better clinical effects than cilostazol alone in treatment of patients with LEADDP.