硫酸氢氯吡格雷治疗68例2型糖尿病患者下肢动脉病变的疗效观察  

The investigation of the effects of Clopidogel on the arterial angiopathies of lover extremity in 68 patients with 2 diabetes

作　　者：顾平[1] 鲁一兵[2] 

机构地区：[1]南京市市级机关医院内分泌科,210018 [2]南京医科大学第二附属医院内分泌科

出　　处：《中国临床实用医学》2009年第11期6-8,共3页China Clinical Practical Medicine

摘　　要：目的 观察硫酸氢氯吡格雷片治疗68例2型糖尿病患者下肢动脉病变的疗效。方法通过下肢血管彩超和踝肱比（ABI）测量明确有下肢动脉病变的2型糖尿病患者98例，随机分为硫酸氢氯吡格雷组（68例），阿司匹林组（30例），分别给与硫酸氢氯吡格雷75mg，1次／d，阿司匹林肠溶片75mg，1次／d，共6个月。观察治疗前后2型糖尿病患者下肢动脉病变的症状、股动脉、胭动脉、足背动脉的内径、血流速度和ABI的变化。结果硫酸氢氯吡格雷治疗组总有效率81．38％，阿司匹林治疗组总有效率52．24％，2组疗效差异具有显著性。治疗中无严重不良反应发生。硫酸氢氯吡格雷治疗组2型糖尿病患者胭动脉、足背动脉的内径增大，血流速度增加；ABI明显升高，差异均具有显著性。阿司匹林治疗组2型糖尿病患者胭动脉、足背动脉内径增大，血流速度有所增加，ABI有所升高，但差异无显著性。结论硫酸氢氯吡格雷通过对血小板聚集的影响，能明显改善2型糖尿病患者下肢动脉的血流，可用于2型糖尿病下肢动脉病变的治疗。Objective To investigate the effects of Clopidogrel on the arterial angiopathies of lower extremity in 68 patients with type 2 diabetes. Methods 98 type 2 diabetic patients with lower extremity arterial disease diagnosed by ankle-brachial index（ ABI） and color Dopplor were randomly divided into two groups, Clopidogrel group which received the treatment of Clopidogrel 75 mg a day for 6 months, Aspirin group which received the treatment of Aspirin 75 mg a day for 6 months. Before and after treatment, the inner diameter of the femoral artery,popliteal artery, dorsal pedal artery and the blood current velocity of lower extremity and ABI were measured by Doppler. The clinic symptoms of lower extremity and the side effects were also observed. Results In Clopidogrel group, the inner diameters of popliteal artery, dorsal pedal artery and the maximum velocity of blood current in artery of lower extremity were increased significantly, P value 〈 0. 05. The inner diameters of each artery and blood current velocity in the Aspirin group showed some improvement but without significant difference（ P value 〉 0. 05 ）. The efficacy rates of the treatment in Clopidogrel group reached 81.38% and 52.24% in Aspirin group, the difference of the efficacy rate in two groups was significant（ P value 〈 0. 05 ）. No remarkable adverse reactions occurred during the study. Conclusoin Long-term Clopidogrel therapy could effectively delay the progression of angiopathy in artery of lower extremity in patients with type 2 diabetes.

关 键 词：2型糖尿病 下肢动脉病变 硫酸氢氯吡格雷 DOPPLER 阿司匹林 踝肱比 

分 类 号：R587[医药卫生—内分泌]