经皮腔内血管成形术治疗下肢闭塞性动脉硬化患者的疗效及对ABI指数的影响

Efficacy of percutaneous transluminal angioplasty on arteriosclerosis obliterans of lower extremity and its effect on ABI

目的探讨经皮腔内血管成形术治疗下肢闭塞性动脉硬化患者的疗效及对踝肱指数(ABI)指数的影响。方法选取2015年6月至2019年5月于遂宁市中心医院行手术治疗的108例下肢闭塞性动脉硬化患者的病历资料,根据治疗方式不同分为观察组(n=59)和对照组(n=49)。观察并比较两组患者治疗前后的ABI、间歇性跛行距离、血管通畅率、最小管腔直径(MLD)、远期管腔丢失(LLL)及血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)差异。结果术前,两组患者ABI值、间歇性跛行距离、MLD、LLL值比较,差异无统计学意义(P>0.05);术后3 d、术后3、6个月,观察组患者ABI、MLD值均高于对照组患者(P<0.05)。术后3、6个月,观察组患者间歇性跛行距离均大于对照组患者(P<0.05);LLL值均低于对照组患者(P<0.05)。术前及术后3 d,两组患者的血清hs-CRP、TNF-α、IL-6水平比较,差异无统计学意义(P>0.05);观察组和对照组术后3 d的血清hs-CRP、TNF-α、IL-6水平均较本组术前增高,差异均有统计学意义(P<0.05)。结论经皮腔内血管成形术联合支架植入术治疗下肢闭塞性动脉硬化的效果优于动脉内剥脱术,术后患者管腔维持更好。

Objective To explore the efficacy of percutaneous transluminal angioplasty in patients with arteriosclerosis obliterans of lower extremity and its effect on ankle brachial index(ABI).Method The medical records of 108 patients with occlusive arteriosclerosis of lower extremity treated in Suining Central Hospital from June 2015 to May 2019 were divided into observation group(n=59)and control group(n=49).The ABI,intermittent claudication distance,vascular patency rate,minimum lumen diameter(MLD),long-term lumen loss(LLL),serum high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were observed and compared between the two groups before and after treatment.Result There was no significant difference in ABI value,intermittent claudication distance and ML、DLLL value between the two groups before operation(P>0.05).The ABI、MLD values of the patients in the observation group were higher than those in the control group 3 d,and 6 months after operation(P<0.05).The intermittent claudication distance in the observation group was higher than that in the control group(P<0.05).The LLL value was lower than that in the control group(P<0.05).There was no significant difference in serum hsCRP、TNF-α、IL-6 level between the two groups before and after operation(P>0.05).The serum hs-CRP、TNF-α、IL-6 levels of the observation group and the control group were increased 3 d after operation,and the difference was statistically significant(P<0.05).Conclusion The effect of percutaneous transluminal angioplasty combined with stent implantation in the treatment of lower extremity arteriosclerosis obliterans is better than that of intraarterial stripping,and the lumen of the patients is maintained better after operation.