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案例患者,女,53岁,因出现末梢局部缺血就诊。该患者13年前被诊断患有2型糖尿病。最初两年给予二甲双胍治疗,之后加用格列苯脲,目前使用胰岛素已经两年,不过,血糖控制仍不理想,糖化血红蛋白为11%。该患者还出现了糖尿病肾病(肾功能正常)、视网膜病变和周围神经病变。该患者体形肥胖,既往患有高血压,目前服用卡托普利、氢氯噻和硝苯地平,平均血为140/80mmHg。无吸烟史。该患者在糖尿病确诊两年后,因湿性坏疽右脚大脚趾被截。一年后,左脚小脚趾和右脚第二个脚趾被截,与此同时,左手中指发生了干性坏疽。一年后(即糖尿
Case patient, female, 53 years old, due to the emergence of peripheral ischemia. The patient was diagnosed with type 2 diabetes 13 years ago. Metformin was given for the first two years, followed by glibenclamide, which has been used for two years now, but glycemic control is still poor, with 11% HbA1c. The patient also developed diabetic nephropathy (normal renal function), retinopathy and peripheral neuropathy. The patient was obese and had previous high blood pressure, currently taking captopril, hydrochlorothiazide, and nifedipine with an average blood level of 140/80 mmHg. No smoking history. The patient was diagnosed with diabetes two years later, because of wet gangrene right foot big toe was cut off. A year later, the left toe and the second toe of the right foot were cut off, while dry gangrene occurred in the left middle finger. A year later (ie diabetes