阿司匹林联合利伐沙班在糖尿病合并严重下肢缺血性血管病变患者下肢动脉腔内成形术后的临床效果  

Clinical Outcomes of Aspirin Combined with Rivaroxaban in Patients with Diabetes Mellitus Complication with Severe Lower Limb Ischemic Vasculopathy after Lower Extremity Arterial Transluminal Plasty

作　　者：孙波[1] 张纪存 曹广信[1] 胡潍青[1] 刘涛[1] 张杰峰[1] SUN Bo;ZHANG Jicun;CAO Guangxin;HU Weiqing;LIU Tao;ZHANG Jiefeng(Department of Vascular Surgery,Weifang People′s Hospital,Weifang 261041,China)

机构地区：[1]潍坊市人民医院血管外科,山东潍坊261041

出　　处：《医学综述》2024年第11期1404-1408,共5页Medical Recapitulate

基　　金：山东省医药卫生科技发展计划项目(202004130167)。

摘　　要：目的探讨阿司匹林联合利伐沙班在糖尿病合并严重下肢缺血性血管病变患者下肢动脉腔内成形术后的临床效果。方法选取2019年8月至2021年9月潍坊市人民医院血管外科收治的行下肢动脉腔内成形术的81例糖尿病合并严重下肢缺血性血管病变患者(均为单侧下肢)为研究对象,根据患者术后维持药物治疗方案不同分为对照组(41例)和观察组(40例)。两组患者均行下肢动脉腔内成形术,术后常规行降糖、降压、降脂等基础治疗。对照组口服阿司匹林(每次100 mg、每日1次)治疗;观察组口服阿司匹林(每次100 mg,每日1次)联合利伐沙班(每次2.5 mg,每日2次)治疗。记录两组患者术前和术后6个月踝肱指数(ABI)、C反应蛋白(CRP)、D-二聚体(DD)、糖化血红蛋白(HbA_(1c))、总胆固醇(TC)水平,术后6个月再狭窄发生情况。同时记录两组患者不良反应发生情况。结果术前和术后6个月,两组间ABI比较差异无统计学意义(P>0.05);术后6个月,两组ABI均明显高于术前(P<0.05)。术后6个月,两组再狭窄率比较差异无统计学意义(P>0.05)。术后6个月,两组患者CRP、DD低于术前(P<0.05),且观察组低于对照组(P<0.01),但两组HbA_(1c)、TC与术前比较差异无统计学意义(P>0.05),且两组间HbA 1c、TC比较差异无统计学意义(P>0.05)。两组患者总不良反应发生率比较差异无统计学意义(P>0.05)。结论与单独使用阿司匹林相比,利伐沙班联合阿司匹林对糖尿病合并严重下肢缺血性血管病变患者术后维持治疗有益,可抑制炎症及血管内斑块的发展,改善患者下肢血管情况。Objective To investigate the clinical effect of aspirin combined with rivaroxaban in patients with diabetes mellitus complicated with severe lower extremity ischemic vasculopathy after lower extremity arterial transluminal plasty.Methods A total of 81 patients with diabetes mellitus combined with severe lower extremity ischemic vasculopathy who underwent lower extremity arterial transluminal plasty in Department of Vascular Surgery of Weifang People′s Hospital from Aug.2019 to Sep.2021 were included as the study objects(all treated with unilateral lower extremity),and were divided into a control group(41 cases)and an observation group(40 cases)according to different postoperative maintenance drug regimens.Both groups underwent arterial transluminal plasty of lower limbs,and basic hypoglycemic,hypotensive and lipid-lowering treatments were given routinely after surgery.The control group was treated with aspirin orally(100 mg each time,once a day);the observation group was treated with aspirin(100 mg each time,once a day)combined with rivaroxaban(2.5 mg each time,twice a day)orally.The levels of ankle brachial index(ABI),C-reactive protein(CRP),D-dimer(DD),glycosylated hemoglobin(HbA_(1c))and total cholesterol(TC)were recorded before and 6 months after surgery,as well as the occurrence of restenosis 6 months after surgery.Meanwhile,the occurrence of adverse reactions in both groups was recorded.Results There was no significant difference in ABI between the two groups before and 6 months after surgery(P>0.05);ABI of both groups 6 months after surgery was significantly higher than before surgery(P<0.05).At 6 months after surgery,there was no significant difference in restenosis rate between the two groups(P>0.05).At 6 months after surgery,the CRP and DD of both groups were lower than before surgery(P<0.05),and the observation group was lower than the control group(P<0.01),but there was no statistically significant difference in HbA 1c and TC of both groups than before surgery(P>0.05),and no significant difference b

关 键 词：糖尿病 下肢缺血 利伐沙班 血管腔内治疗 

分 类 号：R654.4[医药卫生—外科学]