银杏叶提取物注射液联合前列地尔治疗下肢动脉硬化闭塞症的临床研究

Clinical study on Extract of Ginkgo Biloba Leaves Injection combined with alprostadil in treatment of lower limb arteriosclerosis obliterans

目的研究银杏叶提取物注射液联合前列地尔注射液治疗下肢动脉硬化闭塞症的临床疗效。方法选取2016年9月—2017年12月在宝鸡市中心医院就诊的下肢动脉硬化闭塞症患者60例为研究对象,将所有患者随机分为对照组和治疗组,每组各30例。对照组静脉滴注前列地尔注射液,10μg加入到0.9%氯化钠注射液100 m L中,1次/d。治疗组在对照组治疗的基础上静脉滴注银杏叶提取物注射液,5 m L/d。10 d为1个疗程,两组患者共治疗3个疗程,每个疗程中间间隔2 d。观察两组临床疗效,同时比较治疗前后两组患者的动脉硬化指标、凝血和纤溶指标。结果治疗后,对照组和治疗组的总有效率分别为73.33%、93.33%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者踝肱指数(ABI)显著升高,股浅动脉、胫后动脉和足背动脉血管内径和血流量显著升高,峰值流速显著降低,同组治疗前后比较差异具有统计学意义(P<0.05)。治疗后,治疗组动脉硬化指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组纤维蛋白原(FIB)、抗凝血酶III(AT-III)和纤溶酶原激活物抑制剂(PAI-I)水平均显著降低,D-二聚体(D-D)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05)。治疗后,治疗组凝血和纤溶指标显著优于对照组,两组比较差异具有统计学意义(P<0.05)。结论银杏叶提取物注射液联合前列地尔注射液治疗动脉硬化闭塞症具有较好的临床疗效,可以有效改善患者的血凝状态,舒张下肢血管,降低峰值流速,增加血流量,具有一定的临床推广应用价值。

Objective To study the clinical effect of Extract of Ginkgo Biloba Leaves Injection combined with Alprostadil Injection in treatment of lower limb arteriosclerosis obliterans. Methods Patients（60 cases） with lower limb arteriosclerosis obliterans in Baoji Central Hospital from September 2016 to December 2017 were randomly divided into control and treatment groups, and each group had 30 cases. Patients in the control group were iv administered with Alprostadil Injection, 10 μg added into 0.9% Na Cl injection 100 m L, once daily. Patients in the treatment group were iv administered with Extract of Ginkgo Biloba Leaves Injection on the basis of the control group, 5 m L/d. One course had 10 d, and patients in two groups were treated for 3 courses with treatment interval of 2 d. After treatment, the clinical efficacies were evaluated, and the arteriosclerosis indexes, the blood coagulation, and fibrinolysis indicators in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.33% and 93.33%, respectively, and there was difference between two groups（P 〈 0.05）. After treatment, ABI in two groups were significantly increased, and the inner diameter and blood flow of femoral superficial, tibial posterior, and dorsal foot arteries were significantly increased, but peak flow velocity was significantly decreased, and the difference was statistically significant in the same group（P 〈 0.05）. After treatment, the arteriosclerosis indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P 〈 0.05）. After treatment, the levels of FIB, AT-III and PAI-I in two groups were significantly decreased, but D-D levels in two groups were significantly increased, and the difference was statistically significant in the same group（P 〈 0.05）. After treatment, the blood coagulation and fibrinolysis indicators in the treatment group were significantly better than those in the control group, with significant difference between two groups（P 〈 0.05）. Conclusion Extract of Ginkgo Biloba Leaves Injection combined with Alprostadil Injection has clinical curative effect in treatment of lower limb arteriosclerosis obliterans, can effectively improve the blood coagulation state of patients, dilate the blood vessels of lower limbs, reduce peak flow rate, and increase blood flow, which has a certain clinical application value.