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目的探讨前列腺素E1脂微球载体制剂(Lipo-PGE1)联合西洛他唑对老年下肢动脉硬化闭塞症(ASO)的疗效。方法以入院病例号为编号,根据随机数字表,将160例老年ASO患者随机分成3组,Lipo-PGE1组(53例)、西洛他唑组(52例)、联合组(55例)。治疗2个疗程后比较临床疗效、血流动力学变化、甲襞微循环、踝肱指数改善及炎症因子改变情况。结果联合组疗效、总有效率均优于西洛他唑组和Lipo-PGE1组(P<0.05),西洛他唑组和Lipo-PGE1组有效率对比,差异无统计学意义(P>0.05);联合组的足背动脉处的峰值血流速度、血流搏动指数、阻力指数均低于西洛他唑组和Lipo-PGE1组(P<0.05),Lipo-PGE1组峰值血流速度、血流搏动指数、阻力指数均低于西洛他唑组(P<0.05);联合组的甲襞微循环积分和ABI均优于其他2组(P<0.05),Lipo-PGE1组甲襞微循环积分和ABI优于西洛他唑组(P<0.05);联合组的C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)和细胞间黏附分子-1(ICAM-1)均低于其他2组(P<0.05),Lipo-PGE1组CRP、TNF-α、IL-6和ICAM-1低于西洛他唑组(P<0.05)。结论 Lipo-PGE1联合西洛他唑可彼此增加治疗老年ASO的临床疗效,有效改善患者血流动力学水平,临床治疗效果值得肯定。
Objective To investigate the effect of lipo-prostaglandin E1 (Lipo-PGE1) combined with cilostazol on senile lower extremity arteriosclerosis obliterans (ASO). Methods According to the random number table, 160 elderly patients with ASO were randomly divided into three groups: Lipo-PGE1 group (53 cases), cilostazol group (52 cases) and combination group (55 cases). After 2 courses of treatment, the clinical curative effects, changes of hemodynamics, microcirculation of nailfolds, improvement of ankle brachial index and changes of inflammatory factors were compared. Results The combined effect and total effective rate were better than cilostazol group and Lipo-PGE1 group (P <0.05), but there was no significant difference between cilostazol group and Lipo-PGE1 group (P> 0.05 ). The peak blood flow velocity, pulsatile flow index and resistance index of the dorsalis pedis artery in the combined group were lower than those in the cilostazol group and Lipo-PGE1 group (P <0.05). The peak blood flow velocity, Blood flow index and resistance index were lower than that of cilostazol group (P <0.05). The scores of formazan microcirculation and ABI in combination group were better than those in other two groups (P <0.05). The Lipo-PGE1 group The levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and intercellular adhesion molecule (ICAM-1) were lower than those in the other two groups (P <0.05). The levels of CRP, TNF-α, IL-6 and ICAM-1 in Lipo-PGE1 group were lower than those in cilostazol group (P <0.05). Conclusion Lipo-PGE1 combined with cilostazol can increase the clinical efficacy of treatment of senile ASO, effectively improve the hemodynamic level of patients, and the clinical curative effect is worthy of affirmation.