前列地尔和阿司匹林联合硝苯地平治疗雷诺综合征的临床疗效观察

Effect of Lipo PGE1,Aspirin and Nifedipine in the Treatment of Raynaud Syndrome

目的观察前列地尔和阿司匹林联合硝苯地平治疗雷诺综合征的临床疗效。方法选取2009年1月—2013年6月仙居县人民医院急诊内科诊治的雷诺综合征患者80例,采用随机数字表法分为对照组40例、治疗组40例。对照组患者给予硝苯地平片10 mg/次,口服,3次/d。治疗组患者在对照组的基础上,给予前列地尔脂微球注射液10μg静脉滴注,1次/d;阿司匹林肠溶片100 mg口服,1次/d,14 d为1个疗程。记录患者手指苍白、青紫、变红缓解时间,疼痛缓解时间,麻木缓解时间;治疗前后冷水试验和握拳试验阳性率;B超测定收缩期指动脉血流峰值;治疗前后血液流变学指标。结果治疗后,治疗组较对照组手指苍白、青紫、变红缓解时间,疼痛缓解时间,麻木缓解时间均缩短;冷水试验、握拳试验阳性率降低;收缩期指动脉血流峰值升高;全血高切黏度、全血中切黏度、全血低切黏度、血浆黏度、红细胞聚集指数、红细胞刚性指数降低,红细胞变形指数升高(P<0.05)。结论前列地尔、阿司匹林片和硝苯地平片联合用药治疗雷诺综合征疗效显著,三药联合优于单用硝苯地平。

Objective To observe the effect of Lipo PGE1,Aspirin and Nifedipine in the treatment of Raynaud syndrome. Methods 80 patients with Raynaud syndrome admitted to the department of emergency of Xianju People＇s Hospital from January 2009 to June 2013 were randomly divided into control group（40 cases）and treatment group（40 cases）. The control group was given 10 mg Nifedipine tablet three times a day per os,while the treatment group was given additional 10 μg Lipo PGE1 dissolved in 250 ml 0. 9% normal saline solution once a day intravenously and 100 mg Aspirin tablet once a day per os for a treatment course of 14 days. The remission time of pale,blue or red,the remission time of pain,the remission time of numb, the positive rate of the cool water and handgrip testing,the fingers＇ blood peak flow velocity in the heart beating period,hemorheology indexes between the two groups of patients were analyzed after treatment. Results After treatment for 14 days,the remission time of pale,blue or red,the remission time of pain,the remission time of numb were decreased,the positive rate of the cool water and handgrip testing,the fingers＇ blood peak flow velocity in the heart beating period were increased,whole blood high shear viscosity,whole blood middle shear viscosity,whole blood low shear viscosity,plasma,viscosity,the index of erythrocyte aggregation（IEA）,the index of rigid erythrocyte（IRE）were decreased,the index of erythrocyte disfiguration（IED）were increased in the treatment group more obviously than the control group（P〈0. 05）. Conclusion Lipo PGE1,Aspirin and Nifedipine is very effective in the treatment of Raynaud syndrome,and the combination is superior to Nifedipine alone.