2019 年第 10 期 第 14 卷

前列地尔联合依帕司他治疗糖尿病足的临床效果

Clinical effect of alprostadil combined with epalrestat on diabetic foot

作者：张亮张继春庞子轩王玉冰

英文作者：

单位：073000河北省定州市，河北省第七人民医院骨二科（张亮、庞子轩、王玉冰）；050051石家庄，河北医科大学第三医院手外二科（张继春）

英文单位：

关键词：糖尿病足；前列地尔；依帕司他

英文关键词：

• 摘要：

• 【摘要】目的    探讨前列地尔联合依帕司他治疗糖尿病足的应用价值。方法    选取2016年12月至2017年12月河北省第七人民医院收治的糖尿病足患者114例，按照随机数字表法分为对照组与联合组，各57例。对照组患者予以常规护理与治疗，在此基础上，联合组患者予以前列地尔联合依帕司他治疗。比较2组患者治疗2、4周后创面愈合率和治疗前后患肢足背动脉血流动力学、腓总神经传导速度及创面肉芽组织肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、血管内皮生长因子（VEGF）水平。结果    联合组治疗2、4周后创面愈合率均明显高于对照组［（23.6±2.2）%比（15.4±2.4）%、（41.9±4.2）%比（29.6±3.8）%］，差异均有统计学意义(均P＜0.01)。治疗后，联合组足背动脉血流速度、血管内径及腓总神经传导速度均明显优于对照组，创面肉芽组织TNF-α、IL-6水平均明显低于对照组，VEGF水平明显高于对照组，差异均有统计学意义(均P＜0.05)。结论    前列地尔联合依帕司他治疗糖尿病足患者临床效果明显，能够显著改善患肢足背动脉血流动力学及腓总神经传导速度，降低创面肉芽组织TNF-α、IL-6水平，提高VEGF水平，从而改善局部微循环，促进创面恢复。

• 【Abstract】Objective    To explore the effect of alprostadil combined with epalrestat on patients with diabetic foot. Methods    A total of 114 patients with diabetic foot admitted to the Seventh People′s hospital of Hebei Province from December 2016 to December 2017 were randomly divided into control group and observation group, with 57 cases in each group. The control group was treated with routine therapy and nursing care. The observation group was treated with alprostadil combined with epalrestat on the basis of routine treatment. Wound healing was assessed 2 and 4 weeks after treatment. Hemodynamics of dorsal pedal artery and conduction velocity of common peroneal nerve of affected limb, levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and vascular endothelial growth factor(VEGF) in granulation tissue were detected after treatment. Results    The 2- and 4-week wound healing rates in observation group were significantly higher than those in control group［（23.6±2.2）% vs （15.4±2.4）%, （41.9±4.2）% vs （29.6±3.8）%］(P＜0.01). After treatment, blood flow velocity and diameter of dorsal pedal artery and conduction velocity of common peroneal nerve in observation group were higher than those in control group; levels of TNF-α and IL-6 in granulation tissue were lower and VEGF level was higher in observation group than those in control group(all P＜0.05). Conclusion    Alprostadil combined with epalrestat treating diabetic foot can significantly improve hemodynamics of dorsal pedal artery and conduction velocity of common peroneal nerve, reduce TNF-α and IL-6 and increase VEGF in granulation tissue, improve microcirculation and promote wound healing.