盐酸沙格雷酯对糖尿病伴膝下动脉病变球囊扩张成形术后疗效的影响

The effects of sarpogrelate hydrochloride after balloon angioplasty in diabetic below the knee artery lesions

目的:观察盐酸沙格雷酯对糖尿病膝下动脉病变,球囊扩张成形术(PTA)后再狭窄的疗效。方法:选择我科2007年4月至2011年8月收治2型糖尿病合并重症下肢缺血患者46例,男性21例,女性25例,年龄49～93岁,平均73.03岁。所有患者均为单纯膝下3支动脉病变。按随机数字表法将入选患者按1∶1的比例随机分为对照组(拜阿斯匹林)和治疗组(拜阿司匹林联合盐酸沙格雷酯),每组23例。PTA术后基础治疗两组一致,治疗组加用盐酸沙格雷酯片(安步乐克,100 mg,每日3次,日本三菱制药),治疗时间为6个月。疗效观察时间为PTA治疗前、治疗后3个月、6个月。观察项目为静息痛缓解、溃疡愈合、术后成功开通血管通畅及再狭窄的情况,将静息痛完全缓解,或者溃疡愈合评为疗效显著。结果:糖尿病性膝下动脉病变PTA术后,治疗组的症状改善及疗效优于对照组。结论:盐酸沙格雷酯对糖尿病膝下血管病变PTA治疗后,再狭窄的预防、缺血症状的改善有较好的作用。

Objective： To observe the effects of sarpogrelate hydrochloride tablets after balloon angioplasty（PTA） in diabetic below the knee（BTK） artery lesions.Methods： Total 46 cases of diabetes patients with severe lower limb ischemia（CLI） were selected between August 2007 and April 2011.All cases suffered from complete BTK atherosclerotic occlusive disease.Patients consisted of 20 male and 22 female,the average age was 73.03 years（49 to 93 years old）.Selected patients were randomly divided into control group（aspirin） and treatment group（aspirin combined with sarpogrelate hydrochloride）,according to 1∶1 and 21 cases in each group.Foundation treatments after PTA are same,treatment group with sarpogrelate hydrochloride tablets for 6 months（Anplag,100 mg,tid,Mitsubishi pharmaceutical,Japan）.Curative effect observation time node were before PTA,3 m and 6 m after PTA.Observation items were rest pain relief,ulcer healing,recanalization artery patency and restenosis.Complete rest pain remission,or ulcer healing were regarded as significant curative effect.Results： The symptomatic improving and curative effect in treatment group is better than the control group for diabetic BTK artery lesions after PTA.Conclusion： Sarpogrelate hydrochloride tablets for diabetic BTK artery lesions after PTA therapy can prevent recanalization artery restenosis,ischemia symptoms reproduce.