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
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篇名: 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
TITLE:
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 mL+0.9%氯化钠注射液100 mL,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(P<0.05)。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(P>0.05);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(P<0.05)。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(P>0.05)。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 investigate the clinical efficacy and safety of cilostazol combined with alprostadil in the treatment of peripheral arterial disease (PAD). METHODS: A total of 68 PAD patients in our hospital from Jan. 2015 to Jan. 2016 were divided into observation group (34 cases) and control group (34 cases) according to random number table.  Control group was given basical treatment, and Alprostadil injection 2 mL+0.9% Sodium chloride injection 100 mL, ivgtt, qd. Observation group was additionally given Cilostazol tablets 100 mg, po, bid, on the basis of control group. Both groups were treated for 30 days. Clinical efficacies of 2 groups were observed. The hemorheology indexes (hematocrit, whole blood high-shearing viscosity, erythrocyte aggregation index, erythrocyte deformation index, plasma viscosity), inflammatory factor indexes (TNF-α, IL-6, IL-8, hs-CRP), oxidation stress indexes (GSH-Px, SOD, T-Aoc, MDA), arteriosclerosis indexes (ABI, TBI, dorsalis pedis artery blood flow) were determined before and after treatment. The occurrence of ADR was recorded. RESULTS: Total response rate of observation group (91.18%) was significantly higher than that of control group (79.41%), with statistical significance (P<0.05). Before treatment, there was no statistical significance in hemorheology indexes, inflammatory factors indexes, oxidant stress indexes or arteriosclerosis indexes between 2 groups (P>0.05). After treatment, hematocrit, whole blood high-shearing viscosity, erythrocyte aggregation index, erythrocyte deformation index, plasma viscosity, the levels of TNF-α, IL-6, IL-8, hs-CRP and MDA in 2 groups were decreased significantly; while the levels of GSH-Px, SOD, T-Aoc, ABI, TBI and dorsalis pedis artery blood flow were increased significantly; the improvement of above indexes in observation group was significantly better than control group, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between observation group (14.71%) and control group (11.76%) (P>0.05). CONCLUSIONS: For PAD, cilostazol combined with alprostadil can effectively improve hemorheology indexes, inflammatory factor indexes, oxidation stress indexes and arteriosclerosis indexes with good safety.
期刊: 2017年第28卷第17期
作者: 周志向,陈圆,周家春,黄田
AUTHORS: ZHOU Zhixiang,CHEN Yuan,ZHOU Jiachun,HUANG Tian
关键字: 西洛他唑;前列地尔;下肢动脉硬化闭塞症;血液流变学;炎症因子;氧化应激;动脉硬化
KEYWORDS: Cilostazol; Alprostadil; Peripheral arterial disease; Hemorheologys; Inflammatory factor; Oxidation stress; Arteriosclerosis
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