目的 探讨药物涂层球囊扩张成形术对下肢动脉硬化闭塞症患者血流重建及踝肱指数的影响。方法 选取西安交通大学第一附属医院血管外科2021年7月至2022年8月选择入组的100例下肢动脉硬化闭塞症患者为研究对象，按照随机数字表法分为2组，各50例。对照组患者采用普通球囊扩张成形术治疗，观察组患者实施药物涂层球囊扩张成形术治疗，2组术后均随访6个月。对比2组患者的治疗效果、Rutherford分级、血清水平、血流重建、晚期管腔丢失情况、不良事件。结果 术后6个月，观察组的踝肱指数(0。94±0。26)、最小管腔直径(3。47±0。39)mm、一氧化氮(NO)(30。3±4。0)pg/ml、世界卫生组织生存质量测定量表(WHOQOL-BREF)(80。1±3。5)分均高于对照组的(0。86±0。11)、(3。13±0。32)mm、(26。8±3。6)pg/ml、(68。1±3。1)分，观察组的 Rutherford 分级(0。19±0。05)、血清内皮素-1(ET-1)(70±7)pg/ml、血浆 P 选择素(30。2±3。5)µg/L、晚期管腔丢失(1。24±0。25)mm 低于对照组的(1。42±0。10)、(77±7)pg/ml、(37。3±3。9)µg/L、(2。51±0。36)mm，差异均有统计学意义(P＜0。05);观察组血流重建率为16％，与对照组的32％相比，差异无统计学意义(P＞0。05);观察组的不良事件发生率为4％，低于对照组的16％，差异有统计学意义(P＜0。05)。结论 相比于普通球囊扩张成形术治疗，采用药物涂层球囊扩张成形术应用于下肢动脉硬化闭塞症患者效果更佳，能够有效改善Rutherford分级，提高踝肱指数，降低肢内再狭窄、晚期管腔丢失及不良事件的发生率，值得推广。
Effects of drug coated balloon angioplasty on blood flow reconstruction and ankle brachial index in patients with arteriosclerosis obliterans of the lower extremities
Objective To investigate the effect of drug coated balloon angioplasty on blood flow reconstruction and ankle brachial index in patients with arteriosclerosis obliterans of the lower extremities.Methods One hundred patients with arteriosclerosis obliterans of lower limbs selected from vascular surgery of the First Affiliated Hospital of Xi'an Jiaotong University from July 2021 to August 2022 were selected as research objects,and were divided into two groups according to random number table,50 patients in each group.Patients in the control group were treated with conventional balloon dilatation and angioplasty,while patients in the observation group were treated with drug coated balloon dilatation and angioplasty.Both groups were followed up for 6 months after surgery.The treatment effect,Rutherford grade,serum level,blood flow reconstruction,late lumen loss,and adverse events were compared between the two groups.Results Six months after surgery,the ankle brachial index(0.94±0.26),minimum lumen diameter(3.47±0.39)mm,nitric oxide(NO)(30.3±4.0)pg/ml,and World Health Organization Quality of Life Scale(WHO QOL BREF)(80.1±3.5)scores in the observation group were higher than those in the control group(0.86±0.1 1),(3.13±0.32)mm,(26.8±3.6)pg/ml,and(68.1±3.1)scores.The Rutherford grade in the observation group(0.19±0.05)scores,serum endothelin 1(ET-1)(70±7)pg/ml,plasma P selectin(30.2±3.5)mg/L,late lumen loss(1.24±0.25)mm were lower than those in the control group(1.42±0.10),(77±7)pg/ml,(37.3±3.9)mg/L,(2.51±0.36)mm,the differences were statistically significant(P＜0.05).The blood flow reconstruction rate in the observation group was 16％,which was not significantly different from 32％in the control group(P＞0.05).The incidence of adverse events in the observation group was 4％,lower than 16％in the control group,with a statistically significant difference(P＜0.05).Conclusion Compared with conventional balloon angioplasty,drug coated balloon angioplasty is more effective in the treatment of patients with arteriosclerosis obliterans of the lower extremities,which can effectively improve the Rutherford grade,increase the ankle brachial index,and reduce the incidence of intra limb restenosis,late lumen loss,and adverse events.It is worth promoting.
万方数据
维普
