前列腺素E_1脂微球载体制剂联合西洛他唑治疗下肢动脉硬化闭塞症临床研究
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摘要
目的探讨前列腺素E1脂微球载体制剂(Lipo-PGE_1)联合西洛他唑治疗下肢动脉硬化闭塞症的临床疗效。方法选取医院2016年10月至2017年10月收治的下肢动脉硬化闭塞症患者60例,按随机数字表法分为对照组和联合组,各30例。对照组患者单纯采用西洛他唑治疗,联合组患者采取西洛他唑联合Lipo-PGE1治疗,疗程均为4周。结果联合组治疗总有效率为93. 33%,高于对照组的80. 00%(P <0. 05);治疗后,两组患者C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、细胞间黏附分子-1(ICAM-1)、峰值血流速度、血流搏动指数及甲襞微循环积分均较治疗前下降(P <0. 05),且联合组上述指标水平均低于对照组(P <0. 05);两组踝肱指数(ABI)升高,且联合组高于对照组(P <0. 05);两组不良反应发生率及截肢率比较无明显差异(P> 0. 05)。结论西洛他唑联合Lipo-PGE1治疗下肢动脉硬化闭塞症,效果显著,能显著减轻炎性反应,改善血流动力学,且安全性好。
Objective To investigate the clinical effect of prostaglandin E_1 lipid microsphere carrier preparation( Lipo-PGE_1) combinedwith cilostazol in the treatment of lower extremity arteriosclerosis obliterans. Methods Totally 60 patients with lower extremity arte-riosclerosis obliterans admitted to our hospital from October 2016 to October 2017 were selected and divided into the control group andthe combined group according to the random number table method, 30 cases in each group. The patients in the control group weretreated with cilostazol alone, while the patients in the combined group were treated with cilostazol combined with Lipo-PGE1. Thecourse of treatment was 4 weeks. Results The total effective rate of the combined group was 93. 33%,which was higher than 80. 00%of the control group( P < 0. 05). After treatment,the levels of C-reactive protein( CRP),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α) and intercellular adhesion molecule-1( ICAM-1),the peak blood flow velocity,blood flow pulsation index and nail fold mi-crocirculation integral in the two groups were lower than those before treatment( P < 0. 05), and the above indexes in the combinedgroup were lower than those in the control group( P < 0. 05). The ankle brachial indexes( ABI) of the two groups were increased,andthat of the combined group was higher than that of the control group( P < 0. 05). There were no significant differences in the incidencerate of adverse reactions and amputation rate between the two groups( P > 0. 05). Conclusion Cilostazol combined with Lipo-PGE_1 inthe treatment of lower extremity arteriosclerosis obliterans has a significant effect and safety,which can significantly reduce inflammatoryresponse and improve hemodynamics.
Objective To investigate the clinical effect of prostaglandin E_1 lipid microsphere carrier preparation( Lipo-PGE_1) combinedwith cilostazol in the treatment of lower extremity arteriosclerosis obliterans. Methods Totally 60 patients with lower extremity arte-riosclerosis obliterans admitted to our hospital from October 2016 to October 2017 were selected and divided into the control group andthe combined group according to the random number table method, 30 cases in each group. The patients in the control group weretreated with cilostazol alone, while the patients in the combined group were treated with cilostazol combined with Lipo-PGE1. Thecourse of treatment was 4 weeks. Results The total effective rate of the combined group was 93. 33%,which was higher than 80. 00%of the control group( P < 0. 05). After treatment,the levels of C-reactive protein( CRP),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α) and intercellular adhesion molecule-1( ICAM-1),the peak blood flow velocity,blood flow pulsation index and nail fold mi-crocirculation integral in the two groups were lower than those before treatment( P < 0. 05), and the above indexes in the combinedgroup were lower than those in the control group( P < 0. 05). The ankle brachial indexes( ABI) of the two groups were increased,andthat of the combined group was higher than that of the control group( P < 0. 05). There were no significant differences in the incidencerate of adverse reactions and amputation rate between the two groups( P > 0. 05). Conclusion Cilostazol combined with Lipo-PGE_1 inthe treatment of lower extremity arteriosclerosis obliterans has a significant effect and safety,which can significantly reduce inflammatoryresponse and improve hemodynamics.
引文
[1]庄金满,李选,李天润,等.股浅动脉重建对下肢动脉硬化闭塞症治疗的随机病例对照研究[J].北京大学学报(医学版),2017,49(1):153-157.
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[9]刘颖,李志琛,梅伟群,等.前列腺素E1微脂球制剂联合缬沙坦逆转早期糖尿病肾病的远期疗效研究[J].重庆医学,2014,43(13):1613-1615.
[10]周榕,彭道泉,黄浩波.西洛他唑联合尼可地尔治疗下肢动脉硬化闭塞症的疗效[J].心血管康复医学杂志,2016,25(3):299-301.
[11]牟财国,蔡杨阳,王弋萍,等.前列腺素E1脂微球载体制剂联合西洛他唑治疗老年下肢动脉硬化闭塞症的疗效分析[J].中华全科医学,2017,15(3):427-430.
[12]苑冰,衣卫东.糖尿病下肢动脉硬化闭塞症的中西医结合治疗效果观察[J].实用心脑肺血管病杂志,2014,22(11):89-90.
[13]周志向,陈圆,周家春,等.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[J].中国药房,2017,28(17):2402-2405.
[14] NAU JY. Arteriosclerosis obliterans of lower limbs:early diag-nosis before symptoms[J]. Rev Med Suisse,2015,11(481):1458-1459.
[2]陈旭姣,畅智慧,刘兆玉.药物涂层球囊治疗股动脉硬化闭塞症的临床疗效及安全性[J].中国介入影像与治疗学,2018,15(3):139-143.
[3]宋希涛,刘暴,刘昌伟,等.下肢动脉硬化闭塞症合并无症状颈动脉狭窄发生率及危险因素分析[J].中华医学杂志,2016,96(2):126-128.
[4]郑新杰,郑丹丹,张保朝,等.脂微球化前列腺素E1联合血塞通静滴治疗下肢动脉硬化闭塞症46例[J].山东医药,2016,56(15):77-78.
[5]庄丽华,胡家才,吴昊.中药联合前列腺素E1治疗下肢动脉硬化闭塞症疗效观察[J].现代中西医结合杂志,2015,24(3):267-268.
[6]曲良超,王凤芝,罗和国,等.超声引导双心房输注去氧肾上腺素和前列腺素E1对急性肺动脉高压犬肺损伤的保护作用[J].广东医学,2014,35(1):47-50.
[7]胡伟,顾俊,余强,等.前列腺素E1对急性冠脉综合征患者PCI术后内皮功能的影响[J].国际心血管病杂志,2015,42(2):115-118.
[8]庄丽华,胡家才,吴昊.加味四妙勇安汤联合前列腺素E1治疗下肢动脉硬化闭塞症的临床疗效[J].微循环学杂志,2014,24(2):42-45.
[9]刘颖,李志琛,梅伟群,等.前列腺素E1微脂球制剂联合缬沙坦逆转早期糖尿病肾病的远期疗效研究[J].重庆医学,2014,43(13):1613-1615.
[10]周榕,彭道泉,黄浩波.西洛他唑联合尼可地尔治疗下肢动脉硬化闭塞症的疗效[J].心血管康复医学杂志,2016,25(3):299-301.
[11]牟财国,蔡杨阳,王弋萍,等.前列腺素E1脂微球载体制剂联合西洛他唑治疗老年下肢动脉硬化闭塞症的疗效分析[J].中华全科医学,2017,15(3):427-430.
[12]苑冰,衣卫东.糖尿病下肢动脉硬化闭塞症的中西医结合治疗效果观察[J].实用心脑肺血管病杂志,2014,22(11):89-90.
[13]周志向,陈圆,周家春,等.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[J].中国药房,2017,28(17):2402-2405.
[14] NAU JY. Arteriosclerosis obliterans of lower limbs:early diag-nosis before symptoms[J]. Rev Med Suisse,2015,11(481):1458-1459.