目的 探究曲美他嗪治療糖尿病下肢動脈硬化閉塞癥膝下遠(yuǎn)端動脈病變的臨床療效。方法 選取2017年5月—2018年5月天津市人民醫(yī)院血管中心收治的113例糖尿病下肢動脈硬化閉塞癥膝下遠(yuǎn)端血管病變患者，按照隨機(jī)數(shù)字表法將所有患者分為對照組（54例）和治療組（59例）。對照組給予抗血小板、擴(kuò)血管、降血脂、降糖等常規(guī)治療。治療組在對照組治療基礎(chǔ)上口服鹽酸曲美他嗪緩釋片，20 mg/次，3次/d。兩組均連續(xù)治療1個月。觀察兩組的臨床療效，隨訪12個月，比較兩組治療1、3、6、12個月的血管累積通暢率、ABI指數(shù)、跛行距離。結(jié)果 治療后，治療組的總有效率為96.61 %，明顯高于治療組的85.19%，組間差異具有統(tǒng)計學(xué)意義（P<0.05）。治療1、3、6、12個月，治療組患者血管累積通暢率、ABI及跛行距離均明顯高于對照組（P<0.05）。結(jié)論 曲美他嗪治療糖尿病下肢動脈硬化閉塞癥具有較好的療效，可提高血管累積通暢率、ABI及跛距，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of trimetazidine in treatment of diabetic lower extremity arteriosclerosis occlusive disease distal arterial disease below the knee. Methods A total of 113 patients with diabetic lower extremity arteriosclerosis occlusive syndrome and distal vascular lesions below the knee were selected and treated in Diagnosis and Treatment Center of Vascular Disease of Tianjin People's Hospital from May 2017 to May 2018. All patients were divided into control group (54 cases) and treatment group (59 cases) according to random number table method. Patients in the control group were given routine treatment such as antiplatelet, vasodilator, lowering blood lipid and blood glucose. Patients in the treatment group were additionally given Trimetazidine Dihydrochloride Modified Release Tablets, 20 mg/time, 3 times daily. Both groups were treated continuously for 1 month. The clinical efficacy of the two groups was observed. Follow-up period was 12 months, and the cumulative patency rate, ABI index and claudication distance of the two groups were compared after 1, 3, 6 and 12 months of treatment. Results After treatment, the total effective rate of the treatment group was 96.61%, which was significantly higher than that of the treatment group (85.19%), and the difference between groups was statistically significant (P < 0.05). After 1, 3, 6 and 12 months of treatment, the cumulative patency rate, ABI and claudication distance in the treatment group were significantly higher than those in the control group (P < 0.05). Conclusion Trimetazidine has a good effect in the treatment of diabetic lower extremity arteriosclerosis occlusion, and can improve the cumulative patency rate of blood vessels, ABI and claudication, which has certain clinical application value.

R977