CAJ | 학술논문

目的观察贝前列素钠对老年下肢动脉闭塞症(LEAOD)患者血管内皮功能失调的疗效及安全性. 方法 80例≥60岁下肢动脉闭塞症患者随机分为对照组(40例)及治疗组(40例),2组均常规应用降压、降糖、降脂、抗血小板等基础药物治疗及戒烟、足部保健等非药物治疗,治疗组加用贝前列素钠40 μg/次,3次/d,口服,疗程30 d.观察两组治疗前后症状、体征、肝肾功能、血液流变学和血清一氧化氮(NO)变化. 结果治疗30 d后,2组患者均未发生严重不良反应,治疗组和对照组的总有效率分别为80％和35％(x2=19.60,P＜0.01).血浆黏度、红细胞聚集指数和NO对照组治疗前分别为(1.70±0.19) mpas.s、5.69±1.08和(43.86±5.20) μmol/L,治疗后分别为(1.36±0.14) mpas.s、3.23±0.67和(56.84±7.05) μmol/L;治疗组治疗前分别为(1.71±0.18)mpas.s、5.70±1.04和(44.24±5.40) μmol/L,治疗后分别为(1.10±0.12) mpas.s、2.80±0.52和(64.00±8.15) μmol/L;2组血浆黏度、红细胞聚集指数均较治疗前均明显降低(t=9.07、12.17、17.85、15.76,均P＜0.05)；血清NO水平较治疗前相比明显升高(t=9.38,12.78,P＜0.05)；治疗组血浆黏度、红细胞聚集指数较对照组明显降低(t=8.91,3.27,P＜0.05),血清NO水平明显高于对照组(t=4.21,P＜0.05). 结论口服贝前列素钠可以有效改善老年下肢动脉闭塞症患者的血液流变性和血管内皮功能,疗效显著,安全性良好.
목적 관찰패전렬소납대노년하지동맥폐새증(LEAOD)환자혈관내피공능실조적료효급안전성. 방법 80례≥60세하지동맥폐새증환자수궤분위대조조(40례)급치료조(40례),2조균상규응용강압、강당、강지、항혈소판등기출약물치료급계연、족부보건등비약물치료,치료조가용패전렬소납40 μg/차,3차/d,구복,료정30 d.관찰량조치료전후증상、체정、간신공능、혈액류변학화혈청일양화담(NO)변화. 결과 치료30 d후,2조환자균미발생엄중불량반응,치료조화대조조적총유효솔분별위80％화35％(x2=19.60,P＜0.01).혈장점도、홍세포취집지수화NO대조조치료전분별위(1.70±0.19) mpas.s、5.69±1.08화(43.86±5.20) μmol/L,치료후분별위(1.36±0.14) mpas.s、3.23±0.67화(56.84±7.05) μmol/L;치료조치료전분별위(1.71±0.18)mpas.s、5.70±1.04화(44.24±5.40) μmol/L,치료후분별위(1.10±0.12) mpas.s、2.80±0.52화(64.00±8.15) μmol/L;2조혈장점도、홍세포취집지수균교치료전균명현강저(t=9.07、12.17、17.85、15.76,균P＜0.05)；혈청NO수평교치료전상비명현승고(t=9.38,12.78,P＜0.05)；치료조혈장점도、홍세포취집지수교대조조명현강저(t=8.91,3.27,P＜0.05),혈청NO수평명현고우대조조(t=4.21,P＜0.05). 결론 구복패전렬소납가이유효개선노년하지동맥폐새증환자적혈액류변성화혈관내피공능,료효현저,안전성량호.
Objective To investigate the therapeutic effects and safety of beraprost sodium on vascular endothelial dysfunction in elderly patients with lower extremity arteriosclerotic occlusive disease (LEAOD).Methods A total of 80 patients with LEAOD were randomly divided into 2 groups:the treatment group and the control group (n=40 each group).All patients were treated with conventional antihypertensive,antidiabetic,hypolipidemic,antiplatelet drug therapy and non-drug therapy such as smoking cessation,foot care.In addition,patients in the treatment group received 40 μg oral beraprost sodium at a dose of 120 μg/day,3 times/day for 30 days.The changes in symptoms,vital signs,the function of liver and kidney,hemorheology,and serum nitric oxide (NO)were observed before and after the treatment.Results No adverse reactions happened among all patients.After 30 days treatment,there was a significant difference in the total efficacy between the treatment and control groups (80％ vs.35％,x2 =19.60,P＜0.01).The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the control group were (1.70±0.19) mpas.s,5.69±1.08,(43.86±5.20) μmol/L,respectively before the treatment and (1.36±0.14) mpas.s,3.23±0.67,(56.84 ± 7.05) μmol/L,respectively after the treatment.The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the treatment group were (1.71 ±0.18) mpas.s,5.70±1.04,(44.24±5.40) μmol/L,respectively before the treatment and (1.10±0.12) mpas.s,2.80 ±0.52,(64.00±8.15) μmol/L,respectively after the treatment.Compared with pretreatment,the levels of plasma viscosity and erythrocyte aggregation index in the two groups were significantly decreased and serum NO level was increased after the treatment (t=9.07,12.17,17.85,15.76,9.38,12.78,respectively,all P＜0.05).Compared with the control group,the levels of plasma viscosity and erythrocyte aggregation index in the treatment group were significantly decreased and serum NO level was increased (t =8.91,3.27,4.21,all P＜0.05).Conclusions The oral beraprost sodium can effectively and safely improve the hemorheologic and endothelial function in elderly patients with LEAOD.