| At present, with the development of economics, as a systemic metabolic diseases, the prevalence rate of diabetes has gradually increased. Diabetic lower extremity vascular disease (LEADDP) is diabetic big vascular disease, which causes lower extremity arteries obstruction. It is an important reason leading to the amputation of the leg ,and this is the primary reason for many national non-traumatic amputation of the leg. So far, there is no magic way to prevent their deterioration and cure LEADDP completely. Accordingly, approaching its pathogenesis , designating more effective prevention and treatment methods have become the common research topics for clinicians. In recent years , there have been many researches about the pathogenesis of the LEADDP , but it has not been fully explained. Diabetic patients with lower extremity vascular lesions are affected by many factors, in addition to genetic factors, diabetes duration ,age and other factors, the important risk factors for LEADDP are high blood sugar, high blood pressure, abnormal lipid metabolism, as well as obesity, smoking.。Alprostadil injection has been widely applied in clinical trials with significant effect and non-toxic side effects. It is a natural prostaglandin (PG) type substances and a powerful vasodilator with a variety of biological activity. Treatment of LEADDP with alprostadil is multifaceted, it can inhibit platelet aggregation, thromboxane A2 production, atherosclerosis, lipid plaque formation and the role of immune complexes; it can expand peripheral and coronary vascular, and improve the microcirculation reperfusion, lower peripheral resistance and blood pressure. In recent years, Alprostadil injection has made good effect by widely used in clinical, it has high value of clinical application for the treatment of LEADDP. Because it needs to be preserved with low temperature (0 ~ 5℃), its storage condition is harsh , while the emulsion of Alprostadil injection is sterile lyophilized powder ,which is derived from the change in dosage form of Alprostadil injection, it can be preserved in the shade. We selected 52 patients who admitted to the Endocrinology in the Second Hospital of Jilin University, from January 2006 to December 2007. We analyzed and reviewed the clinical effect and the adverse reactions of Alprostadil dry emulsion in the treatment of diabetic lower extremity vascular disease.ObjectiveTo observe the clinical effect and the adverse reactions of Alprostadil dry emulsion in treatment of diabetic lower extremity vascular disease.Methods52 cases of patients were randomly divided into dry milk group (28 cases) and Kenema group (24 cases),the patients in dry milk group were given Alprostadil dry emulsion 10ug, the patients in Kenema group were given Alprostadil injection 10 ug ,the drug in the two group were added into 0.9% NaCl solution 100 ml intravenous four weeks,seperately. Observations of patients before and after treatment: 1) signs indicators: heart rate, blood pressure; 2) clinical symptoms: pain, numbness, skin temperature, ischemic ulcer area, the largest distance of intermittent claudication, ankle brachial index (ABI); 3) safety indicators: blood (WBC, RBC, HB, PLT), coagulation 4 (PT, TT, TC, FIB), lipid 4 (CHO TG), liver and kidney function (ALT, AST, Cr, BUN). Compare the difference of the relevant indicators before and after test.Results The patients of lower extremity vascular disease with diabetes after the treatment of Alprostadil, clinical symptoms were significantly improved in both groups before and after treatment by integral, there were significant difference(P <0.01), there was no significant difference between the two groups in Integral margin (P> 0.05), in signs indicators and safety indicators before and after test.ConclusionAlprostadil dry emulsion can significantly improved the clinical symptoms, there was no obvious adverse reactions during the course of treatment. Alprostadil dry emulsion can cure diabetic lower extremity vascular lesions safely and effectively. The major hazards of diabetes are its chronic complications.
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