前列地尔联合西洛他唑治疗下肢动脉粥样硬化症临床观察

Clinical observation of alprostadil combined atherosderosis

目的观察前列地尔与西洛他唑联用治疗下肢动脉粥样硬化症的疗效。方法下肢动脉粥样硬化症患者62例，按随机数字表法分为西洛他唑组（单用西洛他唑100mg，2次／d，口服）和联合治疗组（在西洛他唑治疗基础上予前列地尔10μg溶解于0．9％氯化钠100ml静脉滴注，1次/d），每组31例，均治疗4周。比较两组治疗前后主观症状、踝，肱指数（ABI）、6min步行试验（6-MWT）距离和足背动脉血流量改变情况。结果两组患者治疗后6-MWT距离、ABI、足背动脉血流量均较治疗前有明显改善（P〈0．05或〈0．01）。且联合治疗组治疗后6-MWT距离、足背动脉血流量显著高于同期西洛他唑组[（425．4±138．5）m比（379．5±124．6）m，（0．77±0．18）ml／（s·cm^2）比（0．66±0．14）ml／（s·cm^2）]（P〈0．05）。联合治疗组冷感总有效率显著高于西洛他唑组[87．5％（21／24）比61．9％（13／21）]（P〈0．05）。结论前列地尔联合西洛他唑治疗下肢动脉粥样硬化症安全有效。

Objective To observe the curative effect of alprostadil combined with cilostazol intreatment of patients with lower limb atherosclerosis. Methods Sixty-two patients with lower limb atherosclerosis were divided into cilostazol group （cilostazol 100 mg,2 times a day, oral） and therapeutic alliance group （cilostazol 100 mg,2 times a day, oral; alprostedil 10μ g dissolved in 100 ml intravenous infusion of 0.9% sodium chloride, once a day） by random number table with 31 cases each. The changes ofankle-braehial index （ABI）, distance of 6-minute walk test （6-MWT） and the dorsal blood ilow were compared before and after treatment. Results 1 After treatment, the distance of 6-MWT, ABI and the level of dorsal blood flow were significantly improved in two groups （P〈 0.05 or 〈 0.01 ）. Distance of 6,MWT and the level of dorsal blood flow in therapeutic alliance group was significantly higher than that in cilostazol groupafter treatment [ （425.4 ± 138.5） m vs[ （379.5± 124.6） m, （0.77±0.189 ml/ （s-cm^2） vs. （0.66 ±0.14） ml/（ s-cm^2 ）] （P 〈 0.05 ）. The total effective rate in the treatment of significantly higher than that in eilostasol group [87.5%（21/24） vs.61/.9%（ 13/21 ） ]（P 〈 0.05 ）. Conclusion Alprostadil combined with cilostazol is safe and effective in treating lower limb atherosclerosis.