糖尿病伴发下肢动脉硬化性闭塞症的介入治疗分析

目的 探讨糖尿病伴发下肢动脉硬化性闭塞症的介入治疗效果.方法 将46例（53条）糖尿病并发下肢动脉硬化性闭塞症患者作为研究对象,所有患者均术前进行CTA检查,进行介入治疗,术中进行DSA检查,比较治疗后Fontatine分型的疗效情况及治疗前、后患者的血液流变性.结果 46例患者治疗后Fontatine Ⅰ、Ⅱ型有效率均为100.0％,FontatineⅢ型有效率69.2％,Fontatine Ⅳ型有效率53.8％,Fontatine Ⅰ、Ⅱ的疗效显著高于FontatineⅢ（x 2=4.062,P=0.044）及Fontatine Ⅳ（x2=6.769,P=0.009）;治疗后与治疗前的股动脉收缩峰值流速[（76.53±18.96） cm/svs.（68.18±14.79） cm/s）]、平均血流速度[（48.59± 12.26） cm/s vs.（44.10 ±13.27） cm/s）]、血流量[（840.80±51.13）ml/min vs.（796.21±48.16）ml/min）]及搏动指数[（4.16±0.59）vs.（4.83±0.86）]、血流指数[（0.63±0.09）vs.（0.81±0.20）],均P＜0.05.结论 介入治疗在糖尿病伴发下肢动脉硬化闭塞症中Fontatine Ⅰ、Ⅱ有效率显著高于FontatineⅢ、Ⅳ,并可有效改善患者的血液流变性.

Interventional treatment for diabetes complicated with lower limb arteriosclerosis obliterans

Objective To explore the efficacy of interventional treatment for diabetes complicated with lower limb arteriosclerosis obliterans.Methods 46 patients with diabetes complicated with lower limb arteriosclerosis obliterans were selected as study objects.All the patients were checked with CTA before the operation,then were treated interventionally,and were checked with DSA during the operation.The efficacies of different Fontatine types were compared after the treatment.The hemorrheology before the treatment was compared with that after the treatment.Results The efficacy was 100.0% in Fontatine Ⅰ and Ⅱ,69.2% in Fontatine Ⅲ,and 53.8% in Fontatine Ⅳ.The efficacies of Fontatine Ⅰ and Ⅱ were significantly higher than that of Fontatine Ⅲ （x 2=4.062,P=0.044） and Fontatine Ⅳ （x 2=6.769,P=0.009）.Femoral artery systolic peak velocity was （76.53 18.96） cm/s before the treatment and （68.18 ±14.79） cm/s after the treatment,mean flow velocity （48.59 ± 12.26） cm/s and （44.10 ± 13.27） cm/s,blood flow （840.80 ± 51.13） ml/min and （796.21 ± 48.16） ml/min,pulsatility index （4.16 ± 0.59） and （4.83 0.86）,and flow index （0.63 ± 0.09） and （0.81 ± 0.20）,with statistical differences （P 〈 0.05）.Conclusions Interventional treatment for Fontatine Ⅰ and Ⅱ diabetes complicated with lower limb arteriosclerosis obliterans has better efficacy than that for Fontatine Ⅲ and Ⅳ and can effectively improve the patient＇s hemorrheology.