阿司匹林联合利伐沙班对下肢动脉硬化闭塞症术后疗效及再狭窄的影响

Effect of aspirin combined with rivaroxaban on postoperative efficacy and restenosis of lower extremity arteriosclerosis obliterans

目的探讨阿司匹林联合利伐沙班对下肢动脉硬化闭塞症血管内介入术后疗效及再狭窄(ISR)的影响。方法收集2020年6月至2022年6月于江阴市人民医院接受血管内介入术的100例下肢动脉硬化闭塞症患者的临床资料,根据血管内介入术后药物治疗方案的不同将患者分为双抗组(给予双联抗血小板药物治疗)和联合组(给予阿司匹林联合利伐沙班治疗),每组50例。比较两组患者的手术相关信息和随访结果。结果两组患者的病变长度、参考血管直径、治疗方式、手术时间比较,差异均无统计学意义(P﹥0.05)。所有患者均接受了至少12个月的随访,结果显示,双抗组患者术后6、12个月的踝肱指数均低于联合组患者,差异均有统计学意义(P﹤0.05)。术后12个月,联合组患者再狭窄发生率低于双抗组患者,术后6、12个月的血管通畅率均高于双抗组患者,差异均有统计学意义(P﹤0.05)。随访期间未发生死亡病例,联合组患者的截肢率低于双抗组患者,差异有统计学意义(P﹤0.05)。结论与标准的双联抗血小板方案比较,阿司匹林联合利伐沙班可以改善下肢动脉硬化闭塞症血管内介入术患者的预后,降低再狭窄发生率,并且未增加出血的风险。

Objective To investigate the effect of aspirin combined with rivaroxaban on postoperative efficacy and restenosis in patients with lower extremity arteriosclerosis obliterans undergoing endovascular intervention therapy.Method The clinical data of 100 patients with lower extremity arteriosclerosis obliterans who underwent endovascular intervention at Jiangyin People's Hospital from June 2020 to June 2022 were collected.According to the different drug treatment plans after endovascular intervention,the patients were divided into dual antibody group(treated with dual antiplatelet drugs)and combined group(treated with aspirin combined with rivaroxaban),with 50 patients in each group.The surgical related information and follow-up results between two groups of patients were compared.Result There were no statistically significant differences in the length of lesions,reference vessel diameter,treatment method,and surgical duration between the two groups of patients(P﹥0.05).All patients underwent at least 12 months of follow-up,and the follow-up results showed that the ankle brachial index of patients in the dual antibody group were lower than that of patients in the combined group at 6 and 12 months after surgery,and the differences were statistically significant(P﹤0.05).After 12 months of surgery,the incidence of restenosis in the combination group was lower than that in the dual antibody group,and the vascular patency rate at 6 and 12 months after surgery were higher than those in the dual antibody group,and the differences were statistically significant(P﹤0.05).During the follow-up period,there were no deaths,and the amputation rate of patients in the combination group was lower than that of patients in the dual antibody group,and the difference between the two groups was not statistically significant(P﹤0.05).Conclusion Compared with the standard dual antiplatelet regimen,rivaroxaban combined with aspirin can improve patient outcomes,reduce the incidence of restenosis,and do not increase the risk of bleeding.