药物治疗对外周动脉硬化闭塞症支架术后再狭窄的影响  

The effect of sarpogrelate on in-stent restenosis after percutaneous transluminal angioplasty in peripheral arterial disease

作　　者：刘丹[1] 陈忠[1] 翟梦瑶[1] 何楠[1] 唐小斌[1] 张雪宁[1] 吴庆华[1] 

机构地区：[1]首都医科大学附属北京安贞医院血管外科,100029

出　　处：《中华普通外科杂志》2012年第11期896-899,共4页Chinese Journal of General Surgery

基　　金：北京自然科学基金资助项目（7102046）

摘　　要：目的 研究沙格雷酯在预防外周动脉支架术后支架内再狭窄（ in-stent restenosis,ISR）中的治疗效果.方法 对因外周血管狭窄或闭塞行首次支架术治疗的患者68例分为2组,沙格雷酯组：口服沙格雷酯＋阿司匹林；双抗组：口服氯吡格雷＋阿司匹林.术后即开始分组治疗,6个月后复查血管彩超,比较2组患者支架内再狭窄的发生情况.结果 试验共完成随访62例患者.沙格雷酯组和双抗组各病变部位的狭窄率分别为7.0％比18.1％ （P =0.036）,平均峰值流速比（peaksystolic velocity ratio,PSVR）分别为1.34比2.08（P=0.010）,ISR发生例数为1比10 （P =0.005）,差异均有统计学意义.所有随访患者均未观察到严重不良事件.结论 沙格雷酯与阿司匹林联用,安全有效.沙格雷酯＋阿司匹林与双抗治疗相比,可以显著降低外周动脉支架术后的再狭窄发生率,同时显著减少支架内内膜增殖.Objective To evaluate the impact of sarpogrelate on the in-stent restenosis （ISR） after percutaneous transluminal angioplasty （PTA） in peripheral arterial diseases （PAD）.Methods PAD patients who had PTA for the first time were divided into two groups receiving respectively clopidogrel and aspirin （clopidogrel group） or sarpogrelate and aspirin （sarpogrelate group）.Vascular ultrasonography was performed at 6 months after PTA in all patients to evaluate the degree of ISR.Results 62 patients finished the follow-up visits as required.The in-stent restenosis in the sarpogrelate group and clopidogrel group was 7.0% vs.18.1% （P =0.036）,the peak systolic velocity ratio was 1.34 vs.2.08 （P =0.010） and the cases of ISR was 1 vs.10 （P =0.005） respectively.No patients reported serious adverse events.Conclusions Sarpogrelate combined with aspirin is safe and effective.Compare with clopidogrel and aspirin,sarpogrelate and aspirin can significantly reduce the rate of ISR after PTA and the intimal proliferation in the stent.

关 键 词：动脉闭塞性疾病 支架 支架内再狭窄 盐酸沙格雷酯 

分 类 号：R541.4[医药卫生—心血管疾病]