贝前列素钠联合阿加曲班对老年动脉硬化闭塞症甲襞微循环及行走距离的影响

Effects of Beraprostina combined with Argatroban on nailfold microcirculation and walking distance in elderly patients with arteriosclerosis obliterans

摘要:

目的 探讨贝前列素钠联合阿加曲班对老年动脉硬化闭塞症甲襞微循环及行走距离的影响。方法 选取2019年7月—2021年7月河北北方学院附属第一医院老年医学科收治的120例动脉硬化闭塞症患者为研究对象，按随机数字表法分为观察组和对照组，每组60例。对照组口服贝前列素钠片，观察组在对照组基础上联合阿加曲班注射液治疗。比较两组的疗效及不良反应，比较两组治疗前后初始步行距离、绝对步行距离、管袢形态积分、血液流态积分、袢周状态积分、总积分、收缩期峰值血流速度（PSV）、踝肱指数（ABI）、C反应蛋白（CRP）、单核细胞趋化因子-1（MCP-1）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）的差值。结果 观察组总有效率90.00%显著高于对照组65.00%（P <0.05）。观察组治疗前后初始步行距离、绝对步行距离的差值高于对照组（P <0.05）；观察组治疗前后血液流态积分、袢周状态积分、总积分的差值高于对照组（P <0.05）；观察组治疗前后PSV、ABI的差值高于对照组（P <0.05）；观察组治疗前后CRP、MCP-1、IL-6、TNF-α的差值高于对照组（P <0.05）。观察组和对照组不良反应总发生率分别为20.00%和16.67%，两组比较差异无统计学意义（P >0.05）。结论 贝前列素钠联合阿加曲班治疗老年动脉硬化闭塞症可有效提高患者行走距离，改善甲襞微循环。

Abstract:

Objective To investigate the effect of Beraprostine combined with Argatroban on nailfold microcirculation and walking distance in elderly patients with arteriosclerosis obliterans.Methods A total of 120 patients with arteriosclerosis obliterans who were admitted to the Department of Geriatrics of the First Affiliated Hospital of Hebei Northern University from July 2019 to July 2021 were selected and included in the study, and divided into an observation group and a control group according to the random number table method, with 60 cases in each. The patients in the control group were treated with Beraprost sodium tablets orally, and the patients in the observation group were treated with Argatroban injection on the basis of the control group. The treatment effect and adverse reactions of the two groups were compared. The difference of initial walking distance, absolute walking distance, loop shape score, blood flow pattern score, loop state score, total score, peak systolic blood flow velocity (PSV), ankle brachial index (ABI), C-reactive protein (CRP), monocyte chemokine-1 (MCP-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 90.00%, which was significantly higher than that of the control group (65.00%) (P < 0.05). The difference of initial walking distance and absolute walking distance in the observation group before and after treatment was greater than that in the control group (P < 0.05). The difference of blood flow state integral, loop state integral, and total integral in the observation group before and after treatment was greater than that in the control group (P < 0.05). The difference of PSV and ABI in the observation group before and after treatment was greater than that in the control group (P < 0.05). The differences of CRP, MCP-1, IL-6, and TNF-α in the observation group before and after treatment were greater than those in the control group (P < 0.05). The total incidence of adverse reactions in the observation group and the control group were 20.00% and 16.67%, respectively, with no significant difference (P > 0.05).Conclusion The combination of Beraprostina and Argatroban in the treatment of elderly patients with arteriosclerosis obliterans can effectively increase the walking distance and improve nailfold microcirculation.