药物治疗预防下肢动脉支架成形术后再狭窄的临床观察

目的:观察抗血小板药物在下肢动脉支架成形术后预防再狭窄的效果。方法:收集2008年1月至2010年12月,下肢动脉血管内支架治疗的下肢动脉硬化闭塞症(ASO)患者74例,随机分为治疗组(36例),每日口服盐酸沙格雷脂+拜阿司匹林;对照组(38例)每日皮下注射低分子肝素1 w,并从术后第3天起口服华法令。观察术后6个月、12个月及18个月支架内闭塞、再狭窄以及临床出血。结果:两组患者基本特征比较,差异无统计学意义(P>0.05)。治疗组和对照组:18个月的再闭塞分别是1例和2例,两组比较,差异无统计学意义(P>0.05);支架内再狭窄分别是1例和8例,两组比较,差异有统计学意义(P﹤0.05);出血并发症分别是1例和4例,两组比较差异无统计学意义(P>0.05)。结论:盐酸沙格雷脂联合阿司匹林,可以预防下肢动脉支架成形术后的再狭窄,安全有效。

A clinical trial of using antiplatelet therapy combined with drug treatment to prevent restenosis following artery of lower extremity angioplasty and endovascular stent

Objective:To evaluate therapeutic effects of antiplatelet therapy to prevent restenosis following artery of lower extremity angioplasty and endovascular stent.Methods: We summarized the clinical data of 74 patients with arteriosclerosis obliterans(ASO) lower extremities who were treated with stent implantation from 2008 to 2010.Antiplatelet therapy group receiving sarpogrelate plus aspirin(n=36),control group receiving anticoagulation threapy low molecular weight heparin(LWMH) for 7 d plus longterm warfarin(n=38).The primary endpoint events included major bleeding rate,and composite rate of restenosis and reocclusion.Results:There were no significant differences in the baseline data between these two groups.It was 18 months after operation,the thrombotic occlision was 1 in the antiplatelet group and 2 in control group,and the bleeding was 1 in the antiplatelet group and 4 in control group,There were no significant differences between these two groups(P>0.05).The restenosis was 1 in the antiplatelet group and 8 in control group,it was significant difference(P<0.05).Conclusion: Antiplatelet therapy combined with Sarpogrelate plus aspirin is effective and safe in preventing restenosis following artery of lower extremity angioplasty and endovascular stent.