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目的研究抗血小板联合抗凝治疗预防糖尿病下肢动脉硬化闭塞症(LASO)患者支架植入后再狭窄的临床疗效及安全性。方法收集2014年12月至2015年12月于本院接受介入治疗的65例LASO患者,分为华法林组33例和对照组32例,对照组服用贝前列素钠片、阿司匹林肠溶片,华法林组在对照组的基础上,服用华法林片,术后1年内监测凝血酶功能国际标准化比率(INR)指标。结果与对照组比较,华法林组的再狭窄率降低(15.23%vs 7.81%,P<0.05),术后1年的最小管腔内直径升高[(3.76±0.31)vs(4.68±0.68)mm,P<0.05)];华法林组和对照组术后各个时间点的血浆D-二聚体水平比较,差异有统计学意义(P<0.05);与对照组比较,华法林组出血率降低(14.17%vs 6.89%,P<0.05)。结论抗凝联合抗血小板治疗能够有效预防糖尿病LASO患者支架植入术后再狭窄发生率,疗效及安全性更高。
Objective To study the clinical efficacy and safety of antiplatelet combined with anticoagulant therapy in prevention of restenosis after stent implantation in patients with diabetic lower extremity arteriosclerosis obliterans (LASO). Methods Sixty-five patients with LASO undergoing interventional therapy in our hospital from December 2014 to December 2015 were divided into three groups: 33 in warfarin group and 32 in control group. The control group took beraprost sodium tablets and aspirin enteric-coated tablets The warfarin group was given warfarin tablets on the basis of the control group, and the international standardization ratio (INR) of thrombin function was monitored within 1 year after operation. Results Compared with the control group, the restenosis rate in warfarin group was decreased (15.23% vs 7.81%, P <0.05), and the smallest lumen diameter at 1 year after operation was significantly higher than that in the control group [(3.76 ± 0.31) vs (4.68 ± 0.68 ) mm, P <0.05). There was significant difference in plasma D-dimer levels between warfarin group and control group at various time points after operation (P <0.05). Compared with control group, warfarin Group bleeding rate decreased (14.17% vs 6.89%, P <0.05). Conclusion Anticoagulant combined with antiplatelet therapy can effectively prevent restenosis after stent implantation in diabetic LASO patients with higher efficacy and safety.