动脉闭塞性疾病专题研究(Monographic Study of Arterial Occlusive Diseases)

抗凝联合抗血小板聚集治疗预防糖尿病下肢动脉硬化闭塞症支架植入后再狭窄的疗效分析

Published at: 2015年第24卷第6期

苏少飞 1 , 田玉峰 1 , 陈林宝 1 , 闫波 1
1 宁夏回族自治区银川市第一人民医院 血管外科,宁夏 银川 750021
通讯作者 少飞 苏 Email: zhuanye264@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.06.011
基金:

摘要

目的:探讨抗凝联合抗血小板聚集治疗预防糖尿病下肢动脉硬化闭塞症患者支架植入后再狭窄的临床疗效。方法:将61 例糖尿病下肢动脉硬化闭塞症患者分为观察组(30 例)与对照组(31 例),术后观察组采用华法林+ 西洛他唑治疗,对照组则采用拜阿司匹林+ 西洛他唑治疗。随访1 年,比较两组的再狭窄发生率及其他相关指标。结果:两组术前资料具有可比性。随访期内,观察组术后再狭窄发生率、晚期管腔丢失以及血浆D 二聚体水平均明显低于对照组(均P<0.05),两组术后血小板聚集率、血糖/ 血脂相关指标以及出血事件的发生率差异均无统计学意义(均P>0.05)。结论:抗凝联合抗血小板聚集治疗预防糖尿病下肢动脉硬化闭塞症患者支架植入后再狭窄的安全、有效,值得推荐使用。


Combined anticoagulation and antiplatelet therapy for prophylaxis of restenosis after stent placement for leg atherosclerosis obliterans in diabetic patients

Abstract

Objective: To investigate the clinical efficacy of combined anticoagulation and antiplatelet aggregation therapy in prevention of restenosis after stent placement for leg atherosclerosis obliterans in diabetic patients. Methods: Sixty-one diabetic patients with lower limb atherosclerosis obliterans were designated to observational group (30 cases) and control group (31 cases). Patients in observational group received warfarin plus cilostazol regimen, and aspirin plus cilostazol regimen was used in those in control group. Follow-up was performed for one year, and the incidence of restenosis and other relevant variables were compared between the two groups. Results: The preoperative data were comparable between the two groups. During follow-up, the postoperative incidence of restenosis, late lumen loss and plasma D-dimer level in observation group were significantly lower than those in control group (all P<0.05), while preoperative platelet aggregation rate, and blood glucose/lipidrelated parameters as well as incidence of bleeding events showed no significant difference between the two groups (all P>0.05). Conclusion: Combined anticoagulation and antiplatelet therapy for prophylaxis of restenosis after stent placement for leg atherosclerosis obliterans in diabetic patients is safe and effective, so it is recommended to be used in clinical practice.


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引用本文: 少飞 苏, 玉峰 田, 林宝 陈, 波 闫. 抗凝联合抗血小板聚集治疗预防糖尿病下肢动脉硬化闭塞症支架植入后再狭窄的疗效分析[J]. 中国普通外科杂志, 2015, 24(6): 823-827.
Cite this article as: SU Shaofei, TIAN Yufeng, CHEN Linbao, YAN Bo . Combined anticoagulation and antiplatelet therapy for prophylaxis of restenosis after stent placement for leg atherosclerosis obliterans in diabetic patients[J]. Chin J Gen Surg, 2015, 24(6): 823-827.