西洛他唑联合前列地尔治疗下肢动脉硬化闭塞症的临床观察

发布时间：2018-07-31 19:04

【摘要】：目的:探讨西洛他唑联合前列地尔治疗下肢动脉硬化闭塞症(PAD)的临床疗效及安全性。方法:选择我院2015年1月-2016年1月收治的PAD患者68例,按照随机数字表法分为对照组和观察组,各34例。对照组患者给予基础治疗,并予前列地尔注射液2 m L+0.9%氯化钠注射液100 m L,ivgtt,qd;观察组患者在对照组基础上给予西洛他唑片100 mg,po,bid。两组患者均治疗30 d。观察两组患者临床疗效,检测治疗前后血液流变学指标(血细胞比容、全血高切黏度、红细胞聚集指数、红细胞变形指数和血浆黏度)、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-8和超敏C反应蛋白(hs-CRP)]、氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、总抗氧化能力(T-Aoc)和丙二醛(MDA)]、动脉硬化指标[踝肱指数(ABI)、趾臂指数(TBI)和足背动脉血流量],并记录不良反应发生情况。结果:观察组患者总有效率(91.18%)明显高于对照组(79.41%),差异有统计学意义(P0.05)。治疗前,两组患者血液流变学指标、炎症因子、氧化应激指标和动脉硬化指标水平比较,差异均无统计学意义(P0.05);治疗后,两组患者血细胞比容、全血高切黏度、红细胞聚集指数、红细胞变形指数、血浆黏度、TNF-α、IL-6、IL-8、hs-CRP和MDA水平均明显降低,GSH-Px、SOD、T-Aoc、ABI、TBI和足背动脉血流量水平均明显升高,且观察组上述指标改善程度均明显优于对照组,差异均有统计学意义(P0.05)。观察组不良反应发生率(14.71%)与对照组(11.76%)比较,差异无统计学意义(P0.05)。结论:西洛他唑联合前列地尔治疗PAD疗效确切,可有效改善患者血液流变学、炎症因子、氧化应激及动脉硬化指标,且安全性较高。
[Abstract]:Objective: to evaluate the efficacy and safety of cilostazol combined with alprostadil in the treatment of lower extremity arteriosclerosis obliterans (PAD). Methods: 68 patients with PAD from January 2015 to January 2016 were randomly divided into control group and observation group with 34 cases each. The patients in the control group were given basic treatment and alprostadil injection 2 mL 0.9% sodium chloride injection 100 mL iv gttt QD, while the patients in the observation group were treated with cilostazol tablet 100 mg pobidopyridine on the basis of the control group. Both groups were treated for 30 days. To observe the clinical effect of the two groups, to detect the hemorheological indexes (hematocrit, whole blood high shear viscosity, erythrocyte aggregation index) before and after treatment. Erythrocyte deformability index and plasma viscosity), inflammatory factors [tumor necrosis factor 伪 (TNF- 伪), interleukin-6 (IL-6) IL-8 and hypersensitive C-reactive protein (hs-CRP)], oxidative stress index [glutathione peroxidase (GSH-Px), superoxide dismutase (SOD),] Strength (T-Aoc) and malondialdehyde (MDA), arteriosclerosis index [ankle brachial index (ABI), toe arm index (TBI) and dorsal foot arterial blood flow], and adverse reactions were recorded. Results: the total effective rate in the observation group (91.18%) was significantly higher than that in the control group (79.41%), and the difference was statistically significant (P0.05). Before treatment, there was no significant difference in the levels of hemorheology, inflammatory factors, oxidative stress and arteriosclerosis between the two groups (P0.05). The RBC aggregation index, erythrocyte deformability index, plasma viscosity TNF- 伪 IL-6, IL-8hs-CRP and MDA levels were all significantly decreased in both GSH-PxX SODX T-AocDX ABI TBI and dorsal foot arterial blood flow, and the improvement degree of the above indexes in the observation group was significantly better than that in the control group. The difference was statistically significant (P0.05). The incidence of adverse reactions in the observation group (14.71%) was not significantly different from that in the control group (11.76%) (P0.05). Conclusion: cilostazol combined with alprostadil is effective in the treatment of PAD. It can effectively improve hemorheology, inflammatory factors, oxidative stress and arteriosclerosis in patients with PAD.
【作者单位】：海南省第二人民医院内科;海南省第二人民医院外科;
【分类号】：R543.5

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