CAJ | 학술논문

目的：观察雷公藤多甙对下肢动脉硬化闭塞症腔内治疗后血管支架内再狭窄的干预作用。方法：将下肢动脉闭塞性疾病120例患者成功实施腔内治疗后随机分为对照组、雷公藤多甙低量组及雷公藤多甙高量组各40例，3组均给予基础治疗,治疗组分别口服雷公藤多甙0.5 mg·kg-1·d-1、1 mg·kg-1·d-1，分2次口服，60 d 1个疗程。结果：对照组术后1个月IL-10和IL-18的水平为(33.6±9.6) pg/mL和(68.9±15.1) pg/mL，下肢动脉中膜厚度为(1.49±0.18) mm，均明显高于术前(P＜0.01)。雷公藤多甙低、高量治疗1个月IL-10、IL-18水平为(26..5±7.2) pg/mL 、(55.0±12.1) pg/mL和(22.1±6.3) pg/mL、(42.9±11.3) pg/mL，均明显低于对照组同期(P＜0.01)；两组间比较，高量组明显低于低量组（P＜0.01）。治疗组血管支架通畅率均明显高于对照组（P＜0.05）。结论：雷公藤多甙可能通过免疫抑制作用，降低下肢动脉病变腔内治疗后再狭窄率，改善患肢的缺血症状。
목적：관찰뢰공등다대대하지동맥경화폐새증강내치료후혈관지가내재협착적간예작용。방법：장하지동맥폐새성질병120례환자성공실시강내치료후수궤분위대조조、뢰공등다대저량조급뢰공등다대고량조각40례，3조균급여기출치료,치료조분별구복뢰공등다대0.5 mg·kg-1·d-1、1 mg·kg-1·d-1，분2차구복，60 d 1개료정。결과：대조조술후1개월IL-10화IL-18적수평위(33.6±9.6) pg/mL화(68.9±15.1) pg/mL，하지동맥중막후도위(1.49±0.18) mm，균명현고우술전(P＜0.01)。뢰공등다대저、고량치료1개월IL-10、IL-18수평위(26..5±7.2) pg/mL 、(55.0±12.1) pg/mL화(22.1±6.3) pg/mL、(42.9±11.3) pg/mL，균명현저우대조조동기(P＜0.01)；량조간비교，고량조명현저우저량조（P＜0.01）。치료조혈관지가통창솔균명현고우대조조（P＜0.05）。결론：뢰공등다대가능통과면역억제작용，강저하지동맥병변강내치료후재협착솔，개선환지적결혈증상。
Objective:To observe the intervention and clinical effects of patients with lower extremity arterio?sclerosis obliterans occurred vascular stent restenosis after treatment with tripterygium glycosides. Methods One hundred and 20 cases of lower extremity artery occlusive disease were randomly divided into three groups after treatment with intracavitary therapy (balloon dilation and stent implantation), 40 cases as control group,40 cases as lower dose treatment group with tripterygium glycosides and 40 cases as higher dose treatment group with tripterygium glycosides, The patients of three groups were given basic therapy, those of treatment groups took tripterygium glycosides orally twice a day,60 days a course, the lower dose group took 0.5 mg·kg-1·d-1,the higher dose group took 1 mg·kg-1·d-1. The blood levels of IL-10, IL-18 and Intima-Media Thickness(IMT)of lower extremity artery were detected pre-treatment and 4 weeks and 12weeks after treatment,all patients were followed-up for 6 months,the rates of stent patency and the side effects were observed. Results Five cases had side effects in treatment groups and the side effects went back to normal after the patients stopped treat?ment,the blood levels of IL-10 and IL-18 and Intima-Media Thickness(IMT)of lower extremity artery of the pa?tients was significantly higher after a month of opera?tion than pre-operation in control group (P<0.01), at the same term,the blood levels of IL-10、IL-18 and IMT of lower extremity artery of the patients in <br> the two treatment groups were significantly lower than those in control group(P<0.01),As comparing the blood levels of IL-10, IL-18 and IMT of lower extremity artery of the patients between the two treatment groups after a month of operation, it was significantly lower in the higher dose treatment group than that in lower does treat?ment group but without statistical significance. there was no significant difference between the two treatment groups after 2 months of operation. The rate of stent patency of patients in the treatment group was significantly higher than that in control group. Conclusion Tripterygium glycosides can be used to reduce the rate of vas?cular stent restenosis of the patients with lower extremity arteriosclerosis obliterans by immunosuppressive effect and to improve ischemic symptoms of the limb.