糖尿病足患者血小板相关参数的变化及抗血小板聚集治疗

目的：分析糖尿病足患者平均血小板体积和数量变化的临床意义，同时探讨抗血小板聚集治疗在糖尿病足治疗中的作用。方法：分别测定48例2型糖尿病足患者（糖尿病足组）和30例同龄2型糖尿病无并发症患者（糖尿病组）以及30例健康同龄人（对照组）的平均血小板体积（MPV）、血小板数量（BPC），观察西洛他唑治疗前后12例糖尿病足患者上述参数的变化。结果：糖尿病足组MPV比正常对照组和糖尿病组增大（均P〈0．01），BPC比正常对照组和糖尿病组减少（均P〈0．01）；而正常对照组和糖尿病组之间MPV和BPC差异均无统计学意义（均P〉0．05）。12例糖尿病足患者经西洛他唑治疗后BPC较治疗前明显升高（P〈0．01），MPV与治疗前相比差异无统计学意义（P〉0．05）。结论：糖尿病足除了感染、血管和神经的因素外，血小板在糖尿病足的发病过程也起了重要作用，抗血小板聚集治疗是糖尿病足治疗中的重要措施。

Study on the Changes of the Platelet Parameters and the Clinical Significance of Anti-platelet Therapy in Diabetes Foot

Objective: To study the changes of the platelet parameters and the clinical significance of anti-platelet therapy in diabetes foot. Methods: The mean platelet volume (MPV) and the blood platelet count (BPC) were determined in 48 patients with diabetes foot, 30 type 2 diabetes with no complication and 30 normal controls. MPV and BPC were observed before and after cilostazol administration in 12 diabetes foot. Results: The MPV of diabetes foot group was higher than those of type 2 diabetes with no complication group and normal control group (P < 0.01). The BPC of diabetes foot group was lower than those of other two groups (P < 0.01). There were no significant differences in BPC and MPV between diabetes patients with no complication group and normal control group (P > 0.05). The BPC increased significantly after cilostazol therapy in 12 diabetes foot compared with that before therapy (P < 0.01) and there was no significant difference in MPV between before and after therapy (P > 0.05). Conclusion: Besides infection, vascular and nervous factors, the platelet plays an important role in the course of diabetes foot, and anti-platelet therapy is an important method in diabetes foot.