【摘要】 目的比较药物涂层支架与阿司匹林联合氯吡格雷治疗股腘动脉硬化闭塞症的方法和效果。方法选择2010年3月至2017年1月进行保守或手术治疗股腘动脉硬化闭塞症患者86例(86条肢体)作为研究对象。根据患者是否选择药物支架置入术,将其分为常规治疗组(n=43)和介入治疗组(n=43)。常规治疗组予阿司匹林+氯吡格雷治疗,介入治疗组在此基础上行紫杉醇药物涂层支架置入术。1年治疗期内复查血液流变学变化、血管内径、踝肱指数(ABI)以及比较再狭窄和截肢率。结果治疗前两组血浆黏度、纤维蛋白原及血小板电泳时间、ABI比较无统计学差异(P均> 0. 05)。治疗后1年,介入治疗组血浆黏度、纤维蛋白原及血小板电泳时间均优于常规治疗组(P均<0. 01)。两组治疗后血浆黏度、纤维蛋白原及血小板电泳时间较治疗前降低(P均<0. 01)。治疗后1个月两组ABI均有所提高;治疗后3、6、12个月,两组ABI均逐渐下降;治疗后1、3、6、12个月,介入治疗组ABI均高于常规治疗组(P均<0. 01)。治疗后1年,介入治疗组再狭窄率(23. 25%vs 58. 14%,X~2=10. 840,P=0. 001)、截肢率(2. 33%vs 18. 60%,X~2=4. 468,P=0. 034)显著低于常规治疗组。结论药物涂层支架治疗股腘动脉硬化闭塞症可降低靶血管再狭窄的发生率,并能改善下肢缺血程度以及降低治疗1年后截肢率,明显优于常规药物治疗。更多还原

【Abstract】 Objective To compare the efficacy of drug-eluting stent and aspirin plus clopidogrel for the treatment of femoropopliteal atherosclerotic occlusive disease(FPAOD). Methods Eighty-six FPAOD patients(86 limbs) received conservative or surgical treatment from March 2010 to January 2017 were selected as research objects. The patients were divided into two groups(n = 43 each) according to whether to choose drug stent implantation:routine treatment group and interventional therapy group. The patients in routine treatment group were treated with aspirin plus clopidogrel,and the patients in interventional therapy group were treated with paclitaxel drug-eluting stent implantationon the basis of routine treatment group. During the treatment period of one year,the hemorrheology and ankle brachial index(ABI) were reexamined,and amputation rate was compared. Results There were no significant differences in plasma viscosity,fibrinogen,platelet electrophoresis time and ABI before treatment between two groups(all P > 0. 05). The plasma viscosity,fibrinogen and platelet electrophoresis time one year after treatment in interventional therapy group were superior to those in conventional treatment group(all P < 0. 01). The plasma viscosity,fibrinogen and platelet electrophoresis time after treatment in both two groups were significantly lower than those before treatment(all P < 0. 01). ABIs one month after treatment in both two groups increased to some extent,and the ABIs at 1-,3-,6-and 12-month after treatment in both two groups gradually decreased,but the ABIs in interventional therapy group were significantly higher than those in routine treatment group(all P < 0. 01). One year after treatment,the restenosis rate in interventional therapy group was significantly lower than that in routine treatment group(23. 25% vs 58. 14%,X~2= 10. 840,P = 0. 001),and the amputation rate in interventional therapy group was significantly lower than that in routine treatment group(2. 33% vs 18. 60%,X~2= 4. 468,P= 0. 034). Conclusion For the treatment of FPAOD,drug-eluting stent can reduce the target vessel re-stenosis rate,improve ischemia degree of lower extremity,decrease amputation rate after one year,so it is superior to conventional drug therapy.更多还原