目的 探究曲美他嗪治疗糖尿病下肢动脉硬化闭塞症膝下远端动脉病变的临床疗效。方法 选取2017年5月—2018年5月天津市人民医院血管中心收治的113例糖尿病下肢动脉硬化闭塞症膝下远端血管病变患者，按照随机数字表法将所有患者分为对照组（54例）和治疗组（59例）。对照组给予抗血小板、扩血管、降血脂、降糖等常规治疗。治疗组在对照组治疗基础上口服盐酸曲美他嗪缓释片，20 mg/次，3次/d。两组均连续治疗1个月。观察两组的临床疗效，随访12个月，比较两组治疗1、3、6、12个月的血管累积通畅率、ABI指数、跛行距离。结果 治疗后，治疗组的总有效率为96.61 %，明显高于治疗组的85.19%，组间差异具有统计学意义（P<0.05）。治疗1、3、6、12个月，治疗组患者血管累积通畅率、ABI及跛行距离均明显高于对照组（P<0.05）。结论 曲美他嗪治疗糖尿病下肢动脉硬化闭塞症具有较好的疗效，可提高血管累积通畅率、ABI及跛距，具有一定的临床推广应用价值。

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