前列腺素E1联合硫酸氢氯吡格雷治疗老年下肢动脉硬化闭塞症的效果分析以及对IL-6、TNF-、ICAM-1的表达水平影响

Curative Effect of Prostaglandin E1 Combined with Clopidogrel Bisulfate on Arteriosclerosis Obliterans in Lower Extremity of the Elderly and the Effect on the Expression of IL-6, TNF-and ICAM-1

目的探讨前列腺素E1联合硫酸氢氯吡格雷治疗老年下肢动脉硬化闭塞症的效果分析以及对IL-6、TNF-、ICAM-1的表达水平影响。方法选取2015年8月~2017年8月复旦大学附属华东医院收治的126例下肢动脉硬化闭塞症(ASO)患者作为研究对象,根据随机区组设计法将所有患者分为实验组和对照组(n=63)。实验组采用前列腺素E1联合硫酸氢氯吡格雷治疗,对照组采用前列腺素E1治疗。比较两组患者临床疗效、血流动力学指标、踝肱指数(ABI)、行走距离、血清炎性指标及不良反应发生情况。结果:实验组的总有效率(92.1%)高于对照组(69.8%)(P<0.05),实验组峰值血流速度、搏动指数及阻力指数低于对照组(P<0.05),实验组ABI、无痛行走距离及最大行走距离高于对照组(P<0.05),实验组血清IL-6、TNF-及ICAM-1水平低于对照组(P<0.05)。两组不良反应发生率9.5%,无统计学意义(P>0.05)。结论前列腺素E1联合硫酸氢氯吡格雷可改善老年下肢动脉硬化闭塞症患者的血流动力学指标,降低炎性反应,促进患者患肢的血供恢复,且不增加额外的不良事件发生率。

Objective To discuss the curative effect of prostaglandin E1 combined with clopidogrel bisulfate on arteriosclerosis obliterans（ASO） in lower extremity of the elderly and to analyze the effect on the expression of IL-6, TNF-and ICAM-1. Methods 126 cases with ASO in lower extrmity hospitalized in Huadong Hospital during the period from Aug., 2015 to Aug., 2018 were selected and randomly divided into 2 groups： experiment group and control group, 63 in each; prostaglandin E1 combined with clopidogrel bisulfate was administrated to cases in experiment group while only prostaglandin E1 to cases in control group; a comparative study was made in clinical curative effect, hemodynamic parameters, ankle-brachial index（BAI）,walking distance, serum inflammatory markers and the incidence of adverse reaction between the 2 groups. Results The total effective rate in experiment group was 92.1%, higher than that in control group（69.8%）（ P0.05）; the peak velocity, pulsatility index（PI） and resistance index（RI） in experiment group were lower than those in control group（ P0.05）; the ABI, painless walking distance and maximum distance in experiment group were higher and longer than those in control group（ P0.05）; the expression levels of IL-6, TNF-and ICAM-1 in experiment group were lower than those in control group（ P0.05）; the incidence of adverse reaction in both group was 9.5% with no statistical significance（P 0.05）. Conclusions Prostaglandin E1 combined with clopidogrel bisulfate is of obvious effect in improving the hemodynamic parameters in the elderly with with ASO in lower extrmity, reducing inflammatory reaction and promoting the blood flow recovery with low incidence of adverse reactions.