阿托伐他汀和前列地尔脂微球载体联合高压氧治疗糖尿病下肢血管病变102例疗效观察  

Clinical efficacy of atorvastatin and lipo-prostaglandin E1 combined with hyperbaric oxygen on 102 cases of diabetic lower extremity vascular disease

作　　者：李文波 刁春鹏 于洋 吕兴波 曲乐丰 Li Wenbo;Diao Chunpeng;Yu Yang;Lyu Xingbo;Qu Lefeng(Department of Vascular Surgery,Longkou People’s Hospital,Longkou 265700,China)

机构地区：[1]龙口市人民医院血管外科,山东省烟台265700 [2]海军军医大学第二附属医院(上海长征医院)血管外科

出　　处：《中华航海医学与高气压医学杂志》2020年第5期547-552,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨阿托伐他汀和前列地尔脂微球载体(LipoPGE1)联合高压氧(HBO)治疗糖尿病下肢血管病变的临床效果及其机制。方法回顾性分析2016年10月至2019年10月龙口市人民医院血管外科收治的采取保守治疗的糖尿病下肢缺血性病变患者194例,根据治疗方法分为观察组(n=102)和对照组(n=92)。对照组患者在常规对症治疗的基础上予以阿托伐他汀和LipoPGE1治疗;观察组患者则在对照组治疗的基础上联合HBO治疗。2组患者治疗前后进行间歇性跛行评分和肢体疼痛评分。检测2组患者治疗前后皮温、经皮氧分压(TcPO2)和踝肱指数(ABI)。采用彩色多普勒超声诊断仪检测2组患者治疗前后腘动脉、胫前后动脉、足背动脉收缩期的最高流速(Vmax)、阻力指数(RI)。采用酶联免疫法检测血清炎性因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平;采用荧光法检测C反应蛋白(CRP)水平。采用数字化无创血流动力学检测仪检测2组患者全血高、低、中切,血浆黏度及纤维蛋白原(Fib)水平。结果治疗3个疗程后,2组患者皮温、TcPO2、ABI显著高于治疗前,且观察组患者治疗后皮温、TcPO2、ABI显著高于对照组,差异均有统计学意义(P<0.05);2组患者肢体疼痛评分和间歇性跛行评分显著低于治疗前,且观察组患者治疗后显著低于对照组(P<0.05),差异均有统计学意义;2组患者腘动脉、胫前后动脉及足背动脉Vmax显著高于治疗前,RI显著低于治疗前,且观察组患者治疗后Vmax显著高于对照组,RI显著低于对照组,差异均有统计学意义(P<0.05);2组患者血清TNF-α、IL-6、CRP水平显著低于治疗前,且观察组患者治疗后TNF-α、IL-6、CRP水平显著低于对照组,差异均有统计学意义(P<0.05);2组患者全血高、低、中切,血浆黏度及Fib水平均显著低于治疗前,且观察组患者治疗后上述指标显著低于对照组,差异均有统计学意义(P<0.05)。结论阿托伐他�Objective To investigate the clinical efficacy and mechanism of atorvastatin and Lipo-prostaglandin E1(LipoPGE1)combined with hyperbaric oxygen(HBO)in the treatment of diabetic lower extremity vascular disease.Methods A total of 194 patients with diabetic lower extremity ischemic disease received conservative treatment at the Department of Vascular Surgery of Longkou People’s Hospital from October 2016 to October 2019 were included into a retrospective analysis,who were divided into observation group(n=102)and control group(n=92)according to the treatment.The control group was treated with atorvastatin and LipoPGE1 on the basis of conventional symptomatic treatment,while the observation group was treated with HBO on the basis of that of the control group.The peak systolic velocity(Vmax),resistance index(RI),and ankle brachial index(ABI)of popliteal artery,anterior and posterior tibial artery,and dorsalis pedis artery were measured before and after treatment by color Doppler ultrasound.The skin temperature and transcutaneous oxygen partial pressure(TcPO2)were recorded before and after treatment.The levels of inflammatory factor interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in serum were detected by enzyme-linked immunosorbent assay(ELISA)and that of C-reactive protein(CRP)was detected by fluorescence method.The whole blood high,low,and medium shear rate,plasma viscosity,and fibrinogen(Fib)of the two groups were detected by digital noninvasive hemodynamic detector.Results After 3 courses of treatment,the skin temperature,TcPO2,and ABI of the two groups were significantly higher than those before treatment,and the skin temperature,TcPO2,and ABI of the observation group were significantly higher than those of the control group(P<0.05).The limb pain score and intermittent claudication score of the two groups were significantly lower than those before treatment;and after treatment,the limb pain score and intermittent claudication score of the observation group were significantly lower than those of the contr

关 键 词：阿托伐他汀 前列地尔脂微球载体 高压氧 糖尿病 下肢血管病变 

分 类 号：R587.2[医药卫生—内分泌]