摘要
目的观察合并正常甲状腺功能病态综合征(euthyroid sicks syndrome,ESS)的老年糖尿病足患者行糖尿病足截肢术前、后甲状腺激素水平及血管功能的变化,探讨血必净对其的影响及可能的机制。方法 56例糖尿病足坏疽伴ESS的老年患者在截肢术前随机分为血必净组及对照组,每组28例,两组术后均给予常规治疗,血必净组在常规治疗基础上加用血必净,检测两组在术前、术后1d、7d、12dFT3、T3、FT4的变化及血管功能。结果①与术前比较:对照组术后1d测得T3、FT3水平明显低于术前(均P<0.05),术后12d与术前相似(均P>0.05)。血必净组术后1d、7d测T3、FT3较术前水平低(均P<0.05),术后12d高于术前(均P<0.05)。FT4水平两组各时段与术前比较,差异均无统计学意义(均P>0.05)。②两组同时段比较:血必净组术后7d、12d的T3水平高于对照组(均P<0.05),术后1d、7d和12d的FT3水平明显高于对照组(均P<0.05),两组间FT4水平差异无统计学意义(P>0.05)。③血管内皮依赖性舒张功能:对照组术后12d较术前改善,血必净组术后7d和12d较术前及对照组同时段改善(均P<0.05)。结论糖尿病足截肢术术后ESS状况短时间内较难完全缓解,血必净可促进老年糖尿病足患者截肢术后ESS状况及血管舒张功能的改善。
Objective To examine the effect of Xuebijing on the level of thyroid hormone （TH） and the function of blood vessels in elderly patients with euthyroid sick syndrome （ESS） and diabetic foot who underwent amputation surgery. Methods A total of 56 elderly patients with diabetic foot gangrene and concomitant ESS were randomly divided into two groups before amputation surgery：control group （n=28）, Xuebijing group （n=28）. Patients in both groups were treated with conventional therapy and additionally, those in Xuebijing group were administrated Xuebijing （50 mL thrice daily）. TH and the function of blood vessels were detected before surgery,and 1,7 and 12 days after operation. Resells ①The level of T3 and FT3 in control group was much lower after operation than that before operation on the first day of surgery （P〈0.05）. It was gradually increased and similar to that before operation 12 days after amputation （P〉0.05）. Moreover, the postoperative level of T3 and FT3 in Xuebijing group was significantly lower than the preoperative level on the first and seventh day of surgery （P〈0.05）, but it was much higher at 12 days （P〈0.05）. The postoperative level of serum FT4 in both Xuebijing and control groups was similar to the preoperative level （P〉0. 05）. QThe level of serum T3 was much higher in Xuebijing group than in control group 7 and 12 days after operation （P〈0.05）. The level of FT3 was significantly increased in Xuebijing group when compared with control group 1,7,12 days after operation （P〈0.05）. No significant difference in the level of FT4 was found between the two groups （P〉0. 05）. ③The endothelium-dependent diastolic （EDD） function of blood vessels was improved at 7 and 12 days in two groups （P〈0.05）. EDD function was much better in Xuebijing group than in control group （P〈0.05）. Conclusion It is difficult for ESS patients to obtain complete remission after diabetic foot amputation. Xuebijing can improve the EDD function of bl
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第5期617-619,共3页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金
湖北省卫生厅科研基金资助项目(No.X6B11)
