地奥司明片联合医用弹力袜对非手术下肢静脉曲张患者股静脉超声参数、凝血纤溶参数及预后的影响

Effect of Diosmin Tablets Combined with Medical Elastic Stockings on Ultrasound Parameters of Femoral Vein,Coagulation and Fibrinolysis Parameters and Prognosis in Patients with Non-operative Varicose Veins of Lower Extremities

目的探讨地奥司明片联合医用弹力袜对非手术下肢静脉曲张患者股静脉超声参数、凝血纤溶参数及预后的影响。方法选取2018年1月—2021年1月收治的126例非手术下肢静脉曲张为研究对象,根据治疗方法不同分为研究组和对照组,每组63例。对照组给予医用弹力袜,研究组给予地奥司明片联合医用弹力袜,均治疗3个月。统计2组临床表现-病因学-解剖学-病理生理学(CEAP)分级、不良反应、复发率,以及治疗前后股静脉超声参数[血流峰速度(Vp)、血流量(Bf)、血流平均速度(Va)]、凝血纤溶参数[纤维蛋白原(FIB)、D-二聚体(D-D)、组织型纤溶酶原激活物(t-PA)]、血管内皮功能指标[锌指Krüppel样转录因子2(KLF2)、内皮素-1(ET-1)、一氧化氮(NO)]、静脉临床严重程度评分(VCSS)及视觉模拟评分法(VAS)评分。结果治疗1、3个月时,研究组C0级、C1级所占比例高于对照组(P<0.05)。治疗1、3个月时,研究组股静脉Vp、Bf、Va高于对照组,VCSS和VAS评分低于对照组(P<0.05)。治疗1、3个月时,研究组D-D、FIB、ET-1水平低于对照组,t-PA、NO、KLF2水平高于对照组(P<0.05)。2组不良反应发生率及复发率比较差异无统计学意义(P>0.05)。结论地奥司明片联合医用弹力袜有利于控制非手术下肢静脉曲张患者症状,纠正凝血纤溶功能紊乱,改善股静脉超声参数及血管内皮功能,且安全性高。

Objective To investigate the effects of Diosmin tablets combined with medical elastic stockings on ultrasound parameters of femoral vein,coagulation and fibrinolysis parameters and prognosis of patients with non-operative varicose veins of lower extremities.Methods A total of 126 patients with non-surgical varicose veins of lower extremities treated from January 2018 to January 2021 were selected as the research subjects.They were divided into research group and control group according to different treatment methods,with 63 cases in each group.The control group was given medical elastic stockings,while the research group was given Diosmin tablets combined with medical elastic stockings,and both were treated for 3 months.The clinical manifestations,etiology,anatomy and pathophysiology(CEAP)grades,adverse reactions and recurrence rates of the two groups were analyzed.Ultrasound parameters of femoral vein before and after treatment[peak velocity of blood flow(Vp),blood flow(Bf),mean velocity of blood flow(Va)],coagulation and fibrinolysis parameters[fibrinogen(FIB),D-dimer(D-D),tissue plasminogen activator(t-PA)],vascular endothelial function indicators[zinc finger Krüppel-like transcription factor 2(KLF2),endothelin-1(ET-1),nitric oxide(NO)],venous clinical severity score(VCSS)and visual analog scale(VAS)score in the two groups were recorded.Results At 1 and 3 months after treatment,the proportion of grade C0 and C1 in the research group was higher than that in the control group(P<0.05).At 1 and 3 months after treatment,the Vp,Bf and Va of femoral vein in the research group were higher than those in the control group,while the scores of VCSS and VAS were lower than those in the control group(P<0.05).At 1 and 3 months after treatment,the levels of D-D,FIB and ET-1 in the research group were lower than those in the control group,while the levels of t-PA,NO and KLF2 were higher than those in the control group(P<0.05).There was no significant difference in the incidence and recurrence of adverse reactions between the two groups(P>0.05).Conclusion Diosmin tablets combined with medical elastic stockings are helpful to control the symptoms of patients with non-operative varicose veins of lower extremities,correct coagulation and fibrinolysis dysfunction,improve ultrasound parameters of femoral vein and vascular endothelial function,and have high safety.