阿加曲班联合前列地尔治疗下肢血栓闭塞性脉管炎的临床效果

Clinical Effects of Argatroban Combined with Alprostadil in the Treatment of Lower Extremity Thromboangiitis Obliterans

目的 探讨阿加曲班联合前列地尔治疗下肢血栓闭塞性脉管炎(TAO)的临床效果。方法 回顾性分析2021年1月至2022年6月郑州大学第一附属医院大血管外科收治的88例下肢TAO患者,按照治疗方式分组,对照组(42例)单独接受前列地尔治疗,试验组(46例)在对照组基础上联合应用阿加曲班,治疗周期为14 d。比较两组患者的临床疗效、踝肱指数(ABI)、凝血功能指标、炎症因子指标、不良反应发生情况。结果 试验组总有效率(95.7%)高于对照组(85.7%)(P<0.05)。两组患者治疗前ABI、血浆D-二聚体(D-D)、纤维蛋白原(Fib)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平比较差异无统计学意义(P>0.05)。治疗后两组血浆D-D、Fib、TNF-α、IL-6水平均降低,且试验组低于对照组,ABI均升高,且试验组高于对照组(P<0.05)。治疗期间两组患者不良反应发生情况比较差异无统计学意义(P>0.05)。结论 阿加曲班联合前列地尔治疗下肢TAO的效果较好,可以减轻患者临床症状,控制炎症反应,改善血液高凝状态,提高治疗总有效率,且不增加不良反应。

Objective To explore the clinical effect of argatroban combined with alprostadil in the treatment of lower extremity thromboangiitis obliterans(TAO).Methods Retrospective analysis was performed on 88 patients with lower extremity TAO admitted to the Department of Vascular Surgery of the First Affiliated Hospital of Zhengzhou University from January 2021 to June 2022,and they were divided into groups according to treatment methods.The control group(42 cases)received alprostadil alone,and the experimental group(46 cases)received argatroban on the basis of the control group,the treatment cycle was 14 days.The clinical efficacy,ankle-brachial index(ABI),coagulation function index,inflammatory factor index and adverse reactions of the two groups were compared and analyzed.Results The total effective rate in the experimental group(95.7%)was higher than that in the control group(85.7%)(P<0.05).There were no statistical differences in preoperative ankle-brachial index,blood D-dimer(D-D),fibrinogen(Fib),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels between the two groups(P>0.05).After treatment,the levels of blood D-D,Fib,TNF-αand IL-6 of two groups were decreased than before treatment,and the levels of the experimental group were lower than those of the control group,the preoperative ABI of two groups were increased than before treatment,and the level of the experimental group was higher than that of the control group(P<0.05).In addition,there was no statistical difference in adverse reactions between the two groups during the treatment(P>0.05).Conclusion Argatroban combined with alprostadil has better efficacy in the treatment of lower extremity TAO,which can reduce patients’clinical symptoms,control inflammation,reduce blood hypercoagulability,improve the total effective rate of treatment,and will not increase adverse reactions.