高压氧联合法舒地尔治疗下肢动脉硬化闭塞症51例疗效观察  

Observation on the therapeutic effect of hyperbaric oxygen combined with fasudil in the treatment of lower extremity arteriosclerosis obliterans:a study of 51 cases

作　　者：黄建国 王江杰 刘甲 陈萍 郝清智[2] Huang Jianguo;Wang Jiangjie;Liu Jia;Chen Ping;Hao Qingzhi(Department of Vascular Surgery,Linyi Central Hospital,Linyi 276400,China;Department of Peripheral Vascular Disease,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250000,China)

机构地区：[1]临沂市中心医院血管外科,临沂276400 [2]山东中医药大学附属医院周围血管病科,济南250000

出　　处：《中华航海医学与高气压医学杂志》2024年第2期207-210,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧联合法舒地尔治疗下肢动脉硬化闭塞症的临床疗效及其作用机制。方法选取2018年5月至2021年5月临沂市中心医院血管外科收治的下肢动脉硬化闭塞症患者102例作为研究对象。采用随机数字表法将患者分为对照组和联合组,每组51例。对照组患者在常规对症治疗的基础上予以盐酸法舒地尔治疗,联合组在对照组治疗的基础上予以高压氧辅助治疗。采用血管超声及动脉硬化检测仪测量治疗前后患者血足背动脉血流量,计算耻-肱指数、踝-肱指数,并评估临床治疗效果。采用微量热沉法检测血清纤维蛋白原(FIB)水平,采用酶联免疫吸附法检测血清高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-8(IL-8)水平。采用免疫荧光法检测血清尿酸转运蛋白(UAT)表达水平;采用双抗夹心酶联免疫吸附法检测血清热休克蛋白27(HSP27)表达水平。结果联合组患者治疗总有效率(92.16%)明显高于对照组(76.47%),差异有统计学意义(χ^(2)=4.744,P=0.029)。联合组患者治疗后足背动脉血流量、耻-肱指数、踝-肱指数及血清UAT水平均明显高于对照组,FIB、全血黏度、血浆黏度及血清hs-CRP、TNF-α、IL-8、HSP27水平均明显低于对照组(P<0.05或P<0.01)。结论高压氧联合法舒地尔治疗能明显改善下肢动脉硬化闭塞症患者的血流动力学,减轻炎症反应,延缓下肢动脉硬化的进展,具有较好的临床应用价值。Objective To investigate the clinical efficacy and mechanism of action of hyperbaric oxygen combined with fasudil in the treatment of arteriosclerosis obliterans of lower limbs.Methods A total of 102 patients with lower limb arteriosclerosis obliterans admitted to the vascular surgery department of Linyi Central Hospital from May 2018 to May 2021 were selected and divided into control group and combination group according to the random number table method,with 51 cases in each group.The patients in the control group were given fasudil intravenous injection on the basis of conventional symptomatic treatment,while the patients in the combination group were given hyperbaric oxygen therapy on the basis of the treatments of the control group.Using vascular ultrasound and an arterial sclerosis detector,the blood flow of patients'dorsal pedal arteries was measured before and after treatment.The toe-brachial index(TBI)and ankle-brachial index(ABI)were calculated,and the clinical treatment effect was assessed.The microcalorimetric method was employed to detect the level of fibrinogen(FIB),while the enzyme-linked immunosorbent assay(ELISA)was utilized to detect serum inflammatory indexes including serum high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factorα(TNF-α),and interleukin-8(IL-8).Immunofluorescence was employed to determine serum uric acid transporter protein(UAT)expression levels,and double-antibody sandwich enzyme-linked immunosorbent assay was used to assess serum heat shock protein 27(HSP27)expression level.Results The total effective rate of the combination group was higher than that of the control group(92.16%vs.76.47%),with a statistically significant difference(χ^(2)=4.744,P=0.029).After treatment,the blood flow of dorsalis pedis,the TBI,the ABI,and serum UAT in the combination group were significantly higher than those in the control group;however,the FIB level,whole blood viscosity and plasma viscosity,as well as the levels of hs-CRP,TNF-α,IL-8,and HSP27 in the combination group were signi

关 键 词：下肢动脉硬化闭塞症 高压氧 法舒地尔治疗 

分 类 号：R543.5[医药卫生—心血管疾病]