长球囊血管成形术对糖尿病足凝血及纤溶功能的影响

目的：观察长球囊血管成形术治疗糖尿病足术后凝血和纤溶系统活性的动态变化，探讨长球囊血管成形术预防再狭窄的可能机制。方法：选取糖尿病足患者40例，实验组20例，行长球囊血管成形术，对照组20例行短球囊血管成形术，术前，术后即刻、术后24h采取股静脉血，检测组织型纤溶酶原激活物（t—PA）、纤溶酶原激活物抑制剂（PAI-1）、纤维蛋白肽A（FPA）的含量。结果：两组患者的t—PA含量在术后即刻均降低，术后24h实验组的较术后即刻有明显恢复（P〈0．05），且较对照组的显著（P〈0．05），两组分别为（33．30±3．20）ng／ml，（31．01±0．89）ng／ml。PAI-1含量术后两组均显著升高（P〈0．05），24h两组患者均显著降低，实验组降低更显著（P〈0．05），两组分别为（44．33±0．75）ng／ml，（47．86±2．52）ng／ml。FPA含量术后两组均显著升高（P〈0．05），24h两组均显著降低，实验组降低更显著（P〈0．05）。结论：手术前、后t—PA、PAI-1、FPA含量的变化．提示长球囊血管成形术对糖尿病足治疗有效，可能降低血栓事件发生，预防术后再狭窄。

Effect of long balloon angioplasty on blood coagulative and fibrinolys function in patients with diabetic foot

Objective： To discuss the changes of blood coagulative and fibrinolys after long balloon angioplasty for treating diabetic foot. Methods： Long ballon angyoplasty group （experiment group, n=20） and short balloon angioplasty group （control group, n=20） were implanted in 40 consecutive patients with diabetic foot. Tissue-type plasminogen activator （t-PA）, plasminogen activator inhibitor-1 （PAI-1）, fibrinopeptide （FPA） activity before operation, immediately and 24 h after operation were measured. Results： The content of t-PA of both groups decreased immediately after operation, however, 24 h after operation obviously convalescence in experiment group, and more than that of control group （P〈0.05）, respectively was （33.30±3.20） ng/ml, （31. 01±0.89） ng/ml. The contents of FPA and PAI-1 of two groups significantly increased immediately after operation （P〈0.05）, and 24 h after operation significantly decreased （P〈0.05）, the decreased of experiment group was more than those of control group （P〈0. 05）. Conclusion： The changes of t-PA, PAI-1, FPA contents after long balloon angioplasty suggest that the LBA can reduced the thrombus and is helpful for preventing restenosis in patients with deabetic foot.