经皮腔内血管介入对下肢闭塞性动脉硬化老年患者内皮功能及预后的影响

Effects of percutaneous transluminal vascular intervention on endothelial function and prognosis in elderly patients with lower extremity occluded arteriosclerosis

目的 探究经皮腔内血管介入对下肢闭塞性动脉硬化(ASO)老年患者的跛行距离及内皮因子水平的影响。方法 选取我院2016年12月至2019年12月收治的122例ASO老年患者,根据制定方案的不同分为对照组和观察组。对照组61例行保守治疗,观察组61例在对照组的基础上增加经皮腔内血管介入,对比两组治疗前、治疗6个月后跛行距离、Rutherford分期、踝肱指数(ABI)以及血管内皮功能指标。结果 两组患者治疗6月末跛行距离、ABI水平较治疗前均升高,且观察组高于对照组;观察组治疗6月末Rutherford1~3级发生率93.44%高于对照组73.77%,4~6级发生率6.56%低于对照组26.23%(P<0.05)。两组患者治疗6月末血清一氧化氮(NO)、一氧化氮合酶(NOS)水平均升高,且观察组升高幅度低于对照组;血清内皮素-1(ET-1)水平均降低,且观察组降低幅度高于对照组(P<0.05)。观察组治疗6月末反射亢进、屈伸肌协同运动、协调能力和速度、反射活动评分均高于对照组(P<0.05)。结论 血管内介入治疗对ASO患者可通过改善微循环状态以改善内皮因子水平,促进步态恢复,改善下肢运动功能,提高临高疗效。

Objective To investigate the effects of transdermal vascular intervention on the claudication distance and endothelial factor level in elderly patients with ASO.Methods A total of 122 elderly ASO patients admitted to our hospital from December 2016 to December 2019 were selected and divided into control group and observation group according to different protocols.The 61 patients in the control group received conservative treatment, and the 61 patients in the observation group were added with percutaneous vascular intervention on the basis of the control group.The claudation distance, Rutherford stage, ankle brachial index(ABI)and vascular endothelial function indexes of the two groups were compared before treatment and 6 months after treatment.Results At the end of June, the lameness distance and ABI level in both groups were higher than those before treatment, and the observation group was higher than the control group.At the end of June, the incidence of RutherforD1~3 in the observation group was 93.44% higher than 73.77% in the control group, and the incidence of Level 4~6,6.56% lower than 26.23% in the control group(P<0.05).The serum levels of nitric oxide(NO)and nitric oxide synthase(NOS)in both groups were increased at the end of June after treatment, and the increase in the observation group was lower than that in the control group.Serum endothelin-1(ET-1)levels were all decreased, and the reduction in the observation group was higher than that in the control group(P<0.05).Treatment of hyperreflexia at the end of June in the observation group, flexor and extensor coordinated movement, coordination ability and speed, reflex activity score were all higher than those in the control group(P<0.05).Conclusion Endovascular interventional therapy can improve the level of endothelial factors, promote gait recovery, improve lower limb motor function, and improve the high curative effect in ASO patients by improving microcirculation.