臭氧与丹参酮对下肢动脉硬化闭塞症血管成形术后病人缺血再灌注相关不良反应影响的对比研究

Comparative study on the Effects of Ozone and Tanshinone on Ischemia-reperfusion-related Adverse Reactions after Angioplasty in Lower Extremity Arteriosclerosis Obliterans

目的对比臭氧与丹参酮对下肢动脉硬化闭塞症血管成形术后缺血再灌注相关不良反应的影响。方法回顾性分析2012年3月-2018年3月于我院接受血管成形术治疗的下肢动脉硬化闭塞症病人150例为研究对象。将其按照治疗方式的不同分成研究组(70例)与对照组(80例)。研究组术后第1天开始予以臭氧大自血治疗,对照组术后第1天开始予以丹参酮药物治疗。比较两组缺血再灌注相关不良反应发生情况,术前、术后7 d的肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)水平与疼痛变化情况以及踝肱指数情况。结果研究组单纯肢体肿胀、肢体肿胀伴肤色发红、肢体肿胀伴疼痛发生率相比对照组差异无统计学意义(P>0.05);术后7 d两组CK-MB、CK、LDH水平相比术前较高(P<0.05);而研究组相比对照组差异无统计学意义(P>0.05);术后7 d两组疼痛数字量表评分法(NRS)评分相比术前均较低(P<0.05);但研究组相比对照组差异无统计学意义(P>0.05);术后7 d两组踝肱指数相比术前均较高(P<0.05);但研究组相比对照组差异无统计学意义(P>0.05)。结论臭氧对下肢动脉硬化闭塞症血管成形术后缺血再灌注相关不良反应的预防效果明显,且可有效降低CK-MB、CK、LDH水平,改善病人疼痛程度。臭氧大自血应用于下肢动脉硬化闭塞症病人血管成形术中的手术治疗效果与丹参酮相当。

Objective To study and compare the effects of ozone and tanshinone on ischemia-reperfusion-related adverse reactions after angioplasty in lower extremity arteriosclerosis obliterans(ASO).Methods One hundred and fifty patients with lower extremity ASO undergoing angioplasty in our hospital from March 2012 to March 2018 were divided into two groups:the control group(n=80)treated with ozone,and the study group(n=70)treated with tanshinone for 7 days.The incidence of ischemia-reperfusion-related adverse reactions,the levels of creatine kinase(CK),lactate dehydrogenase(LDH),and creatine kinase isoenzyme(CK-MB),pain and ankle-brachial index were compared between two groups before and 7 days after the operation.Results There was no significant difference in the incidence of simple limb swelling,limb swelling with skin redness,and swelling of the limbs with pain between two groups(P>0.05).The levels of CK-MB,CK,and LDH in two groups at 7 days after operation were higher than that before the operation(P<0.05),but there was no significant difference between two groups(P>0.05).At 7 days after operation,numerical rating scales(NRS)scores and ankle brachial index were lower than those in two groups before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion Ozone has obvious preventive effect on ischemia-reperfusion-related adverse reactions after angioplasty in lower extremity ASO,and can effectively reduce the levels of CK-MB,CK,LDH,and improve the patients′pain,which is similar to tanshinone.