雷红冲剂干预下肢动脉病变腔内治疗后血管支架内再狭窄的临床观察  

Leihong Granule Intervened In-stent Restenosis after Endovascular Therapy for Lower Extremity Arterial Occlusive Diseases: a Clinical Observation

作　　者：韩冰[1] 葛长青[1] 王丽璞[2] 张素芬[1] 李恒周[1] 张宏光[1] 周晨光[1] 吉国辉[1] 杨錚 张亮[1] 

机构地区：[1]河北省保定市第二医院血管外科,河北071051 [2]河北省保定市第一中医院,河北071051

出　　处：《中国中西医结合杂志》2014年第2期153-156,共4页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察雷红冲剂对下肢动脉硬化闭塞症腔内治疗后血管支架内再狭窄(in-stent restenosis,ISR)的干预作用。方法选择下肢动脉闭塞性疾病患者80例,成功实施腔内治疗(球囊扩张并支架植入)后随机分为对照组及雷红冲剂组各40例,对照组给予基础治疗,雷红冲剂组除给予基础治疗外同时口服雷红冲剂3个月。观察两组治疗前、治疗后1、3、6个月血浆IL-10、IL-18、C反应蛋白(CRP)水平、下肢动脉内-中膜厚度(IMT)。同时观察两组血管支架的通畅率、踝动脉收缩压/肱动脉收缩压(ABI)及间歇性跛行、静息痛、截肢的发生率。结果对照组术后1个月,IL-10、IL-18、CRP水平及IMT厚度均明显高于术前,差异有统计学意义(P<0.05)。雷红冲剂组术前IL-10、IL-18、CRP水平及IMT厚度均与对照组比较差异无统计学意义(P>0.05),治疗后均明显低于对照组差异有统计学意义(P<0.05)。与对照组比较,雷红冲剂组术后6个月间歇性跛行及术后12个月间歇性跛行、静息痛发生率均明显降低,而术后6、12个月血管支架通畅率及ABI比值明显增高,差异均有统计学意义(P<0.05);但截肢率差异无统计学意义(P>0.05)。结论雷红冲剂可能通过免疫抑制作用,降低下肢动脉病变腔内治疗后ISR率,改善患肢的缺血症状。Objective To observe the intervention effect of Leihong Granule （LG） in in-stent rest- enosis （ISR） after endovascular therapy for lower extremity arterial occlusive diseases （LEAOD）. Methods Recruited 80 LEAOD patients who successfully underwent endovascular therapy （balloon dilation and stent implantation ） were randomly assigned to two groups, the control group and the LG group, 40 in each group. Patients in the control group received basic treatment, while those in the LG group additionally took LG for 3 months. Plasma levels of IL-10, IL-18, CRP, and the intima-media thickness （IMT） of lower extremity ar- tery were observed in the two groups between and after treatment. The rate of stent patency, ABI, intermit- tent claudication, rest pain, and the incidence of amputation the two groups were recorded and observed in the two groups. Results In the control group, serum levels of IL-10, IL-18, CRP, and IMT were significant- ly higher one month after surgery than before surgery （P 〈0.05）. There was no significant difference in ser- um levels of IL-10, IL-18, CRP, or IMT between the two groups before surgery （P 〉0.05）. These indices were obviously lower in the LG group than in the control group after surgery （P 〈0.05）. Compared with the control group, the incidence rates of intermittent claudication and the rest pain at 6 months and 12 months after surgery significantly decreased （P 〈0.05）. The stent patency rate at 6 months and 12 months after surgery, and ABI were significantly higher than those of the control group （P 〈0.05）. There was no statisti- cal difference in the amputation rate between the two groups （P 〉0.05）. Conclusion LG might effectivelyimprove ischemic symptoms of affected limbs possibly through lowering the ISR rate after endovascular therapy for LEAOD through preventing immunosuppressive actions.

关 键 词：血管支架内再狭窄 下肢动脉病变 免疫排斥反应 雷红冲剂 

分 类 号：R654.4[医药卫生—外科学]