雷公藤多甙干预腔内治疗后血管再狭窄  

Lower Extremity Arteriosclerosis Obliterans Occurred Vascular Stent Restenosis after Treatment with Tripterygium Glycosides

作　　者：韩冰[1] 张宏光[1] 李玉媛[1] 周晨光[1] 吉国辉[1] 杨錚 张亮[1] 赵磊[1] 

机构地区：[1]河北省保定市第二医院血管外科,保定071051

出　　处：《中国中西医结合外科杂志》2015年第3期252-255,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：河北省2013年医学研究课题计划项目(20130015)

摘　　要：目的:观察雷公藤多甙对下肢动脉硬化闭塞症腔内治疗后血管支架内再狭窄的干预作用。方法:将下肢动脉闭塞性疾病120例患者成功实施腔内治疗后随机分为对照组、雷公藤多甙低量组及雷公藤多甙高量组各40例,3组均给予基础治疗,治疗组分别口服雷公藤多甙0.5 mg·kg-1·d-1、1 mg·kg-1·d-1,分2次口服,60 d 1个疗程。结果:对照组术后1个月IL-10和IL-18的水平为(33.6±9.6)pg/m L和(68.9±15.1)pg/m L,下肢动脉中膜厚度为(1.49±0.18)mm,均明显高于术前(P<0.01)。雷公藤多甙低、高量治疗1个月IL-10、IL-18水平为(26..5±7.2)pg/m L、(55.0±12.1)pg/m L和(22.1±6.3)pg/m L、(42.9±11.3)pg/m L,均明显低于对照组同期(P<0.01);两组间比较,高量组明显低于低量组(P<0.01)。治疗组血管支架通畅率均明显高于对照组(P<0.05)。结论:雷公藤多甙可能通过免疫抑制作用,降低下肢动脉病变腔内治疗后再狭窄率,改善患肢的缺血症状。Objective：To observe the intervention and clinical effects of patients with lower extremity arterio-sclerosis obliterans occurred vascular stent restenosis after treatment with tripterygium glycosides.Methods One hundred and 20 cases of lower extremity artery occlusive disease were randomly divided into three groupsafter treatment with intracavitary therapy（balloon dilation and stent implantation）, 40 cases as control group,40 cases as lower dose treatment group with tripterygium glycosides and 40 cases as higher dose treatment groupwith tripterygium glycosides, The patients of three groups were given basic therapy, those of treatment groupstook tripterygium glycosides orally twice a day,60 days a course, the lower dose group took 0.5 mg·kg-1·d-1,thehigher dose group took 1 mg·kg-1·d-1. The blood levels of IL-10, IL-18 and Intima-Media Thickness（IMT）oflower extremity artery were detected pre-treatment and 4 weeks and 12 weeks after treatment,all patients werefollowed-up for 6 months,the rates of stent patency and the side effects were observed.ResultsFive caseshad side effects in treatment groups and the side effects went back to normal after the patients stopped treatment,the blood levels of IL-10 and IL-18 and Intima-Media Thickness（IMT）of lower extremity artery of the patients was significantly higher after a month of opera-tion than preoperation in control group（P 0.01）,at the same term,the blood levels of IL-10、IL-18 and IMT of lower extremity artery of the patients in the two treatment groups were significantly lower than those in control group（P 0.01）,As comparing the bloodlevels of IL-10, IL-18 and IMT of lower extremity artery of the patients between the two treatment groups aftera month of operation, it was significantly lower in the higher dose treatment group than that in lower does treatment group but without statistical significance. there was no significant difference between the two treatmentgroups after 2 months of operation. The rate of stent patency of patients in th

关 键 词：支架内再狭窄 免疫排斥反应 雷公藤多甙 

分 类 号：R654.3[医药卫生—外科学]