两种球囊在下肢动脉硬化闭塞症围术期中应用的效果比较

Perioperative Application of Two Balloon-based Vascular Interventional Surgeries in Lower Extremity Arteriosclerosis Obliterans:a Comparison of Clinical Efficacy

目的 探讨不同球囊在下肢动脉硬化闭塞症(ASO)治疗中的应用价值。方法 选取2020年6月至2022年6月行血管介入手术的106例ASO患者为研究对象,采用电脑随机法分为观察组和对照组,各53例。观察组术中采用药物涂层球囊,对照组术中采用普通球囊。比较2组临床疗效、手术前后氧化应激指标[超氧化物歧化酶(SOD)、硫氧还蛋白(TRX)、髓过氧化物酶(MPO)、丙二醛(MDA)]、血栓前状态指标[血栓前体蛋白(TpP)、血管假血友病因子(vWF)、总同型半胱氨酸(tHcy)]、踝肱指数(ABI)、靶动脉血管内径、Rutherford分级及并发症发生情况。结果 观察组总有效率(92.45%)明显高于对照组(77.36%)(P<0.05);术后3、7 d观察组SOD、TRX水平高于对照组,MPO、MDA水平低于对照组(P<0.05);术后3、7 d观察组TpP、vWF、tHcy水平低于对照组(P<0.05);术后3、7 d观察组ABI、靶动脉血管内径高于对照组(P<0.05);术后12个月观察组Rutherford分级分布优于对照组(P<0.05);2组并发症总发生率比较差异无统计学意义(P>0.05)。结论 两种球囊行血管介入手术治疗ASO患者,均具有较好的安全性,但药物涂层球囊能增强疗效,减轻氧化应激,改善血栓前状态,恢复患者血流,改善患者预后。

Objective To investigate the use of different balloons in the treatment of lower extremity arteriosclerosis obliterans(ASO).Methods A total of 106 patients with ASO who underwent vascular interventional surgery from June 2020 to June 2022 were selected for the study and were divided into the observation group and the control group,each with 53 cases,by using the computerized randomization method.Drug-coated balloons were used intraoperatively in the observation group and plain balloons were used intraoperatively in the control group.Clinical efficacy,oxidative stress indices[superoxide dismutase(SOD),thioredoxin(TRX),myeloperoxidase(MPO),malondialdehyde(MDA)],prethrombotic state-related indicators[thrombus precursor protein(TpP),vascular pseudohaemophilic factor(vWF),total homocysteine(tHcy)],ankle-brachial index(ABI),internal diameter of target artery,Rutherford classification,and complication occurrence were compared in both groups.Results The total effective rate of the observation group(92.45%)was significantly higher than that of the control group(77.36%)(P<0.05);SOD and TRX levels of the observation group were higher than those of the control group whereas MPO and MDA levels were lower than those of the control group at 3 and 7 d postoperatively(P<0.05);the levels of TpP,vWF,and tHcy were lower than those of the control group at 3 and 7 d postoperatively(P<0.05);the ABI and target arterial vascular diameter of the observation group were higher than those of the control group at 3 and 7 d postoperatively(P<0.05);Rutherford grading distribution of the observation group was better than that of the control group at 12 months after surgery(P<0.05);the difference in the total incidence of complications between the 2 groups was not statistically significant(P>0.05).Conclusion Both balloon-based vascular interventional surgeries for treating patients with ASO can have a good safety profile,but the drug-coated balloon might enhance the efficacy,reduce oxidative stress,improve the prethrombotic state,restore blood flow,and improve the patient's prognosis.