小牛血清去蛋白注射液对糖尿病无症状性下肢动脉病变的影响

目的观察小牛血清去蛋白注射液（DCBSI）对糖尿病下肢动脉病变患者早期动脉硬化指标的影响,为糖尿病并发下肢动脉病变的治疗提供依据。方法选取48例糖尿病并发下肢动脉病变患者（PAD组）,随机分为加用DCBSI治疗组24例和对照组24例,并选取未并发PAD的糖尿病患者32例（非PAD组）作为基线时指标对照。治疗前后测定空腹血糖、餐后血糖、糖化血红蛋白（HAb1C）、总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹胰岛素水平,计算胰岛素抵抗指数（HOMA-IR）,并检测颈股脉搏波传导速度（cf-PWV）、心踝血管指数（CAVI）、踝臂指数（ABI）及依赖性血管内皮舒张功能（EDD）。结果 PAD组Hb A1C、甘油三酯、LDL-C、空腹胰岛素及cf-PWV、CAVI均明显高于非PAD组,HDL-C、ABI、EDD均明显低于非PAD组,差异均有统计学意义（P〈0.05,P〈0.01）。应用DCBSI治疗前后比较,治疗组甘油三酯[（2.5±0.52）mmol/L]、空腹胰岛素[（10.2±0.35）m U/L]、HOMA-IR（0.9±0.67）、cf-PWV[（10.0±2.80）m/s]和CVAI（8.2±0.74）较治疗前[分别为（3.0±0.85）mmol/L、（13.9±4.60）m U/L、1.4±0.46、（11.8±3.00）m/s和9.6±1.70]明显降低,EDD（10.3%±2.50%）较治疗前（8.0%±3.20%）明显升高,差异均有统计学意义（P〈0.05,P〈0.01）。对照组治疗后cf-PWV也较治疗前降低,差异有统计学意义（P〈0.05）,但CVAI和EDD差异无统计学意义（P〉0.05）。两组治疗前后ABI指标无明显变化。结论糖尿病确诊初期部分患者已出现动脉粥样硬化和下肢动脉病变,早期检测和干预十分必要。DCBSI是治疗糖尿病下肢动脉病变的有效药物。

Effects of deproteinized calf blood serum injection on peripheral arterial disease in patients with type 2 diabetes

Objective To observe the effects of deproteinized calf blood serum injection（DCBSI） on peripheral arterial disease（PAD） and early arteriosclerosis parameters in patients with type 2 diabetes, and to provide the base for treating the PAD of patients with type 2 diabetes. Methods Forty eighty type 2 diabetes patients with PAD were randomly divided into 24 cases treated with DCBSI（DCBSI group） and control group（24 cases）, 32 type 2 diabetes patients without PAD served as non-PAD group. Before and after DCBSI treatment, the fasting plasma glucose, 2-hour postprandial plasma glucose, Hb A1 C, total cholesterin,triglyceride, HDL-C, LDL-C, fasting insulin and insulin resistance index（HOMA-IR）, carotid-femoral pulse wave velocity（cf-PWV）, cardio-ankle vascular index（CAVI）, ankle-brachial index（ABI） and flow-mediated endothelium-dependent dilatation（EDD） were measured for all subjects. Results Hb A1 C, triglyceride, LDL-C, fasting insulin, cf-PWV and CAVI in PAD group were significantly higher than those in non-PAD group; HDL-C, ABI and EDD in PAD group were significantly lower than those in non-PAD group（P〈0.05 or P〈0.01）. The triglyceride [（2.5±0.52） mmol/L], fasting insulin [（10.2±0.35） m U/L],HOMA-IR（0.9 ±0.67）, cf-PWV [（10.0 ±2.80） m/s] and CAVI（8.2 ±0.74） in DCBSI group after DCBSI treatment were significantly lower than those [（3.0±0.85） mmol/L,（13.9±4.60） m U/L,1.4±0.46,（11.8±3.00） m/s and 9.6±1.70, respectively] in DCBSI group before DCBSI treatment, EDD（10.3%±2.5%） in DCBSI group after DCBSI treatment was significantly higher than that（8.0%±3.20%） in DCBSI group before DCBSI treatment（P〈0.05,P〈0.01）. cf-PWV in control group after DCBSI treatment reduced significantly（P〈0.05） as compared with control group before DCBSI treatment. Conclusion The early arteriosclerosis and PAD can appear in some newly diagnosed patients with type 2 diabetes. It is important for patients with type 2 diabetes to early detect