四虫片预防下肢动脉硬化闭塞症外周动脉支架内再狭窄临床研究

目的探讨四虫片预防下肢动脉硬化闭塞症(LEAD)外周动脉支架内再狭窄(ISR)的临床疗效及作用机制。方法将拟行支架植入术的LEAD患者60例随机分为对照组和四虫片组,对照组采用常规抗血小板及降脂治疗,四虫片组在对照组基础上加用四虫片(2.4 g/次,每日3次)。比较两组支架植入后3、6、12个月的一期通畅率及狭窄程度。术前、术后24 h、3个月检测两组患者血液中的基质金属蛋白酶(MMP-9)、纤维蛋白原(Fib)、肿瘤坏死因子α(TNF-α);术前、术后3个月检测血脂(TC、TG、LDL-C、HDL-C)水平。结果与对照组同期比较,术后12个月支架一期通畅率升高(64.00%vs.53.85%),术后12个月重度狭窄患者的比例降低(20.00%vs.34.601),但差异无统计学意义(P>0.05)。与本组术前比较,两组术后24 h MMP-9、Fib、TNF-α升高(P<0.01),两组术后3个月TC、TG、LDL-C下降,HDL-C升高(P<0.01)。与本组术后24 h比较,术后3个月对照组MMP-9升高(P<0.05),两组Fib降低(P<0.01),四虫片组TNF-α降低(P<0.01)。与对照组同期比较,四虫片组术后3个月Fib及TNF-α降低(P<0.05,P<0.01)。结论四虫片可减轻局部炎症、降低纤维蛋白原,可能具有预防ISR的作用。

Clinical Study of Sichong Tablet on Prevention of Lower Extremities Arteriosclerosis Disease Peripheral Arterial In-Stent Restenosis

Objective To investigate the clinical efficacy and mechanism of Sichong Tablet(SCT) on prevention of lower extremities arteriosclerosis disease(LEAD) peripheral arterial in-stent restenosis(ISR). Methods Totally 60 LEAD patients who had undergone stent implantation were randomly assigned to control group and the SCT group. The standard antiplatelet plus lipid-lowering treatment were used in control group. SCT(2.4 g every time, 3 times per day) was added based on the treatment of control group in SCT group. The first-stage patency rate at 3 months, 6 months, and 12 months after stent implantation and degree of stenosis were compared between two groups. Blood matrix metalloproteinases(MMP-9), fibrinogen(Fib), tumor necrosis factor alpha(TNF-α) were measured before surgery, 24 hours after surgery, and 3 months after surgery. Blood lipids were measured before surgery and 3 months after surgery ResultsCompared with control group, first-stage patency rate at 12 months after stent implantation increased in SCT group(53.85% vs. 64.00%), the proportion of severe stenosis decreased in SCT group(20.00% vs. 34.61%), but the differences were not statistically significant(P>0.05). Compared with before stent implantation, levels of MMP-9, TNF-α and Fib increased in two groups after stent implantation(P<0.01), levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein chesterol(LDL-c)decreased, high density liptein cholesterol increased 3 months after stent implantation in two groups(P<0.01). Compared with 24 h after stent implantation, MMP-P increased in control group(P<0.05), Fib decreased in two groups(P<0.01), TNF-α decreased in SCT group(P<0.01) 3 months after stent implantation. Compared with the same time of control group, Fib, TNF-α decreased in SCT group 3 months after stent implantation(P<0.05,P<0.01). Conclusion SCT can reduce local inflammation and decrease Fib, and it may prevent ISR.