不同剂量阿托伐他汀联合盐酸沙格雷酯对下肢动脉硬化闭塞症介入术后患者的临床效果

Clinical effect of different doses of atorvastatin combined with sarpogrelate hydrochloride in patients with lower extremity arteriosclerosis obliterans after the intervention

目的探讨不同剂量阿托伐他汀联合盐酸沙格雷酯对下肢动脉硬化闭塞症(ASO)介入术后患者的临床效果。方法选取2019年3月至2021年3月川北医学院附属南充市中心医院126例接受ASO介入术的患者为研究对象,采用随机数字表法将其分为阿托伐他汀低剂量组、中剂量组与高剂量组,各42例。低剂量组、中剂量组、高剂量组分别给予10 mg、20 mg、40 mg阿托伐他汀联合盐酸沙格雷酯治疗。对比3组患者治疗前后临床症状评分,血流动力学指标[踝肱指数(ABI)、足背动脉血流量],血管通畅率,临床疗效,血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(D-D)]及治疗期间不良反应。结果治疗后,3组患者疼痛、冰冷感、间歇性跛行评分和TC、TG、LDL-C、Fib、D-D水平均较治疗前降低,ABI、足背动脉血流量均较治疗前升高,PT、APTT均较治疗前延长,差异均有统计学意义(P<0.05)。中剂量组和高剂量组患者疼痛、冰冷感、间歇性跛行评分和TC、TG、LDL-C水平均低于低剂量组患者,ABI、足背动脉血流量均高于低剂量组患者,差异均有统计学意义(P<0.05)。高剂量组患者疼痛、冰冷感、间歇性跛行评分和TC、TG、LDL-C水平均低于中剂量组患者,ABI、足背动脉血流量均高于中剂量组患者,差异均有统计学意义(P<0.05)。3组患者临床疗效等级分布比较,差异有统计学意义(P<0.05)。高剂量组患者总有效率及血管通畅率均高于低剂量组患者,差异均有统计学意义(P<0.05)。治疗期间3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论高剂量阿托伐他汀联合盐酸格雷酯治疗ASO介入术后患者,可显著改善患者的临床症状和血液循环,具有较高的血管通畅率、临床疗效,调脂作用更为明显,且安全性良好。

Objective To investigate the clinical effect of different doses of atorvastatin combined with sarpogrelate hydrochloride after intervention for lower extremity arteriosclerosis obliterans(ASO).Method A total of 126 patients who underwent ASO intervention in the Affiliated Nanchong Central Hospital of North Sichuan Medical College from March 2019 to March 2021 were selected as the research subjects.They were divided into low-dose atorvastatin group,middle-dose group,and high-dose group by the random number table method,with 42 cases in each group.The low-dose group,middle-dose group,and high-dose group were given 10 mg,20 mg,and 40 mg of atorvastatin combined with sarpogrelate hydrochloride,respectively.The clinical symptom scores,hemodynamic indexes[ankle-brachial index(ABI),dorsal artery blood flow],vascular patency rate,clinical efficacy,blood lipid levels[total cholesterol(TC),triacylglycerol,glycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),Fibrinogen(Fib),D-dimer(D-D)]and adverse events during treatment were compared between the three groups.Result After the treatment,the scores of pain,coldness,intermittent claudication,the levels of TC,TG,LDL-C,Fib,and D-D in the three groups were all lower than those before the treatment,the ABI and dorsal foot artery blood flow were higher than those before the treatment,while PT and APTT were longer than those before the treatment,the differences were statistically significant(P<0.05).The pain,coldness,intermittent claudication scores,TC,TG,and LDL-C levels in the middle-dose group and high-dose group were lower than those in the low-dose group,while the ABI and dorsal foot artery blood flow were higher than those in the low-dose group,the differences were statistically significant(P<0.05).The pain,coldness,intermittent claudication scores,TC,TG and LDL-C levels in the high-dose group were lower than those in the middle-dose group,ABI and dorsal artery blood flow were higher than those in the middle-dose group,the differences were statistically significant(P<0.05).The clinical efficacy grade distribution of the three groups was compared,the difference was statistically significant(P<0.05).The total response rate and vascular patency rate in the high-dose group were higher than those in the low-dose group,the differences were statistically significant(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse events among the three groups(P>0.05).Conclusion High-dose atorvastatin combined with sarpogrelate hydrochloride in the treatment of patients after ASO intervention could significantly improve the clinical symptoms and blood circulation of patients,with high vascular patency rate,satisfactory clinical efficacy,obvious lipid-regulating effect,and good safety.