己酮可可碱和贝前列素钠片对糖尿病周围神经病变患者发生下肢动脉硬化闭塞症风险的干预效应及多因素Logistic回归分析

Interventional Effects of Pentoxifylline and Beraprost Sodium Tablets on the Risk of Lower Extremity Arteriosclerosis Occlusive Disease in Patients with Diabetic Peripheral Neuropathy: A Multivariate Logistic Regression Analysis

摘要

目的 分析糖尿病周围神经病变（diabetic peripheral neuropathy，DPN）患者发生下肢动脉硬化闭塞症（lower extremity arteriosclerosis occlusive disease，LEAOD）的危险因素，比较己酮可可碱与贝前列素钠片的疗效与安全性。方法 纳入2023年1月至2025年3月河南科技大学第一附属医院收治的140例DPN患者（80例合并LEAOD为LEAOD组，60例非LEAOD为非LEAOD组），采用多因素Logistic回归筛查LEAOD的危险因素，将80例LEAOD组随机均分并接受己酮可可碱或贝前列素钠片治疗（各40例），评估干预效果。结果 年龄≥60岁、合并冠心病及糖化血红蛋白（glycated hemoglobin，HbA1c）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL-C）、半胱氨酸蛋白酶抑制剂C（cystatin C，CysC）水平高和脂联素水平低是影响DPN患者发生LEAOD的危险因素（P＜0.05）。己酮可可碱组患者的治疗总有效率为87.50%，与贝前列素钠片组患者（77.50%）比较，差异无统计学意义（P＞0.05）；己酮可可碱组患者不良反应发生率为22.50%，与贝前列素钠片组患者（27.50%）比较，差异无统计学意义（P＞0.05）。结论 合并冠心病及HbA1c、LDL-C、CysC高表达和脂联素低表达是DPN患者发生LEAOD的危险因素，己酮可可碱与贝前列素钠片均可作为改善LEAOD的有效药物，临床可基于患者代谢-炎症特征选择靶向干预药物。

Abstract

Objective To analyze the risk factors for the occurrence of lower extremity arteriosclerosis occlusive disease (LEAOD) in patients with diabetic peripheral neuropathy (DPN), and to compare the efficacy and safety of pentoxifylline and beraprost sodium tablets. Methods A total of 140 DPN patients admitted to the First Affiliated Hospital of Henan University of Science and Technology between January 2023 and March 2025 were enrolled, comprising 80 cases with LEAOD (LEAOD group) and 60 cases without LEAOD (non-LEAOD group). Multivariate logistic regression was employed to screen for risk factors. The LEAOD group was then equally randomized to receive either pentoxifylline or beraprost sodium tablets (40 cases each), and the interventional efficacy was evaluated.Results Age ≥ 60 years old, concomitant coronary artery disease, elevated levels of glycated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C) and cystatin C (CysC), as well as decreased adiponectin levels were identified as independent risk factors for LEAOD in DPN patients (P＜ 0.05). The total effective rate was 87.50% in the pentoxifylline group and 77.50% in the beraprost sodium tablet group, with no statistically significant difference observed between the two groups (P＞ 0.05). Similarly, the incidence of adverse reactions did not differ significantly between the pentoxifylline group (22.50%) and the beraprost sodium tablet group (27.50%) (P＞ 0.05). Conclusion Concomitant coronary artery disease and elevated levels of HbA1c, LDL-C and CysC, along with decreased adiponectin levels, are significant risk factors for the occurrence of LEAOD in DPN patients. Both pentoxifylline and beraprost sodium tablets are effective therapeutic options for improving LEAOD. Targeted pharmacological intervention drugs can be selected clinically based on the metabolic-inflammation characteristics of patients.

关键词

糖尿病周围神经病变 / 下肢动脉硬化闭塞症 / 己酮可可碱 / 贝前列素钠片 / 危险因素

Key words

diabetic peripheral neuropathy / lower extremity arteriosclerosis occlusive disease / pentoxifylline / beraprost sodium tablet / risk factor

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基金资助

河南省科技攻关计划联合共建项目(LHGJ20230465)