脉络宁注射液在下肢动脉硬化闭塞症中对血液循环的改善及对血管内皮的影响

康海涵; 李飞; 吴成稳; 崔文军

doi:10.16766/j.cnki.issn.1674-4152.002672

脉络宁注射液在下肢动脉硬化闭塞症中对血液循环的改善及对血管内皮的影响

doi: 10.16766/j.cnki.issn.1674-4152.002672

1.
郑州大学第二附属医院血管外科，河南郑州 450000
2.
郑州大学第五附属医院血管外科

基金项目:

河南省医学科技攻关计划联合共建项目 LHGJ20190420

详细信息

通讯作者:
康海涵, E-mail: lxh157385@163.com

中图分类号: R543.5
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- 被引次数: 0
出版历程
- 收稿日期: 2021-07-15
- 网络出版日期: 2022-11-30

Effect of Mailuoning injection on blood circulation and vascular endothelium in patients with lower extremity arteriosclerosis obliterans

1.
Department of Vascular Surgery, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China

摘要

摘要: 目的探讨脉络宁注射液在下肢动脉硬化闭塞症(ASO)中对血液循环的改善及对血管内皮的影响。方法纳入2018年1月—2020年1月在郑州大学第二附属医院就诊的下肢ASO患者104例，按照随机数字表法分为对照组(52例)和观察组(52例)。对照组采用前列地尔治疗，观察组采用前列地尔联合脉络宁治疗。比较治疗前后2组血液流变学指标、黏附因子、炎症因子水平，比较2组的近期临床疗效及治疗期间的不良反应。结果治疗前2组血浆黏度、红细胞刚性指数、红细胞聚集指数、全血黏度比较，差异无统计学意义(均P＞0.05)，治疗后2组以上指标水平均低于治疗前，且观察组低于对照组(均P＜0.05)。治疗前2组黏附因子血浆内皮素(ET-1)及血清细胞间黏附因子1(ICAM-1)水平比较，差异无统计学意义(均P＞0.05)，治疗后2组ET-1及ICAM-1水平均低于治疗前，且观察组低于对照组(均P＜0.05)。治疗前2组炎症因子IL-6、IL-8、TNF-α及hs-CRP比较，差异无统计学意义(均P＞0.05)，治疗后2组以上指标水平均低于治疗前，且观察组低于对照组(均P＜0.05)。观察组有效率高于对照组(92.31% vs. 76.91%，χ²=4.727，P=0.030)。2组总不良反应发生率(11.45% vs. 9.62%)比较，差异无统计学意义(χ²=0.102，P=0.749)。结论前列地尔联合脉络宁注射液治疗下肢ASO，可改善患者血液流变学指标，调节黏附因子与炎症因子水平，且未增加不良反应，安全性较高，疗效显著。
- 下肢动脉硬化闭塞症 /
- 前列地尔 /
- 脉络宁 /
- 血液循环 /
- 黏附因子
Abstract: Objective To investigate the effect of Mailuoning injection on blood circulation and vascular endothelium in lower extremity arteriosclerosis obliterans (ASO). Methods A total of 104 lower extremity ASO patients treated in the Second Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were enrolled and were divided into control group (52 cases) and observation group (52 cases) according to the random number table method. The control group was treated with Alprostadil injection, and the observation group was treated with Alprostadil injection combined with Mailuoning. The blood rheology indexes, adhesion factors and inflammatory factor levels of the two groups were compared before and after treatment, and the short-term clinical efficacy and adverse reactions during the treatment of the two groups were compared. Results No significant difference in plasma viscosity, erythrocyte stiffness index, erythrocyte aggregation index and whole blood viscosity was found between the two groups before treatment (all P>0.05). After treatment, the levels of five indicators in the two groups were lower than before treatment, and the observation group was lower in the control group (all P < 0.05). No significant differences in the levels of adhesion factor ET-1 and ICAM-1 in the two groups before treatment (all P>0.05). After treatment, the levels of ET-1 and ICAM-1 in the two groups were lower than those before treatment, and the levels in the observation group were lower than those of control group (all P < 0.05). No significant difference in serum inflammatory factors IL-6, IL-8, TNF-α and hs-CRP was found between the two groups before treatment (all P>0.05). After treatment, the levels of four indicators in the two groups were lower than those before treatment, and the observation group had lower levels than the control group (all P < 0.05). The effective rate of the observation group was higher than that of the control group (92.31% vs. 76.91%, χ²=4.727, P=0.030). No serious adverse reactions were observed in the two groups, and the total adverse reaction rate (11.45% vs. 9.62%) was not statistically significant (χ²=0.102, P=0.749). Conclusion Alprostadil combined with Mailuoning injection in the treatment of lower extremity ASO can improve patient ' s hemorheological indexes, regulate the levels of adhesion factors and inflammatory factors without increasing adverse reactions and have high safety and significant efficacy.
- Lower extremity arteriosclerosis obliterans /
- Alprostadil /
- Mailuoning /
- Blood circulation /
- Adhesion factor

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表 1 2组下肢ASO患者血液流变学指标比较(x ±s)

Table 1. Comparison of hemorheology indexes between two groups of patients with ASO(x±s)

组别	例数	血浆黏度(mPa/s)		红细胞刚性指数		红细胞聚集指数		全血黏度高切(mPa/s)		全血黏度低切(mPa/s)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	52	2.13±0.51	1.73±0.26^a	8.63±0.79	6.41±0.57^a	7.59±0.47	5.51±0.36^a	7.78±1.42	5.59±0.59^a	12.31±1.14	9.56±1.47^a
观察组	52	2.11±0.47	1.34±0.29^a	8.76±0.74	5.75±0.32^a	7.60±0.49	2.62±0.27^a	7.81±1.24	3.79±0.39^a	12.34±1.23	7.11±0.62^a
t值		0.208	7.221	0.866	7.281	0.106	46.311	0.115	18.353	0.129	11.074
P值		0.836	< 0.001	0.389	< 0.001	0.916	< 0.001	0.909	< 0.001	0.898	< 0.001
注：与同组治疗前比较，^aP＜0.05。

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表 2 2组下肢ASO患者黏附因子水平比较(x ±s，ng/L)

Table 2. Comparison of adhesion factor levels between two groups of patients with ASO(x ±s, ng/L)

组别	例数	ET-1		ICAM-1
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	52	89.39±8.17	65.53±6.26^a	434.92±43.41	379.41±30.57^a
观察组	52	88.94±8.66	55.34±5.29^a	434.96±43.35	302.75±30.32^a
t值		0.273	8.966	0.005	12.839
P值		0.786	< 0.001	0.996	< 0.001
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组下肢ASO患者血清炎症因子比较(x±s)

Table 3. Comparison of serum inflammatory factors between two groups of patients with ASO(x±s)

组别	例数	IL-6(ng/mL)		IL-8(pg/mL)		TNF-α(pg/mL)		hs-CRP(mg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	52	269.25±25.48	196.74±19.51^a	150.75±14.95	62.44±6.56^a	147.59±11.47	105.51±8.36^a	15.33±1.45	6.77±0.69^a
观察组	52	269.88±24.93	159.82±16.38^a	149.69±14.23	48.57±4.79^a	147.60±11.49	82.62±7.27^a	15.21±1.48	4.59±0.41^a
t值		0.127	10.451	0.149	12.313	0.173	14.899	0.418	19.586
P值		0.899	＜0.001	0.574	＜0.001	0.879	＜0.001	0.677	＜0.001
注：与同组治疗前比较，^aP＜0.05。

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表 4 2组下肢ASO患者近期临床总有效率比较

Table 4. Comparison of short-term total clinical effective rate between two groups of patients with ASO

组别	例数	临床治愈[例(%)]	显效[例(%)]	有效[例(%)]	无效[例(%)]	总有效率(%)
对照组	52	7(13.46)	5(9.62)	28(53.85)	12(23.08)	76.92(40/52)
观察组	52	16(30.77)	14(26.92)	18(34.62)	4(7.69)	92.31(48/52)
注：2组总有效率比较，χ²=4.727，P=0.030。

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表 5 2组下肢ASO患者治疗后总不良反应发生情况比较[例(%)]

Table 5. Comparison of total adverse reactions after treatment between two groups of patients with ASO[cases(%)]

组别	例数	轻度恶心	头晕头痛	心律失常	血压下降	总不良反应发生
对照组	52	2(3.85)	1(1.92)	1(1.92)	2(3.85)	6(11.54)
观察组	52	1(1.92)	1(1.92)	2(3.85)	1(1.92)	5(9.62)
注：2组总不良反应发生率比较，χ²=0.102，P=0.749。

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