The Study Of Treatment By Anisodamine With Percutaneous Transluminal Angioplasty For Inferior Genicular Artery Occlusive Disease

OBJECTIVES:1. To study the effect of anisodamine for the SD rat ischemic hind limb collateral circulation.2. To study the effect of anisodamine combined angioplasty for inferior genicular artery occlusive disease.METHODS:1. To establish the SD rat ischemic hindlimb model, and the thirty SD rat were randomly divided into ischemic treatment group(15 cases)and control group(15 cases). Ischemic treatment group was treated with anisodamine 8 mg/(kg×d)diluted to 0.5 ml,and Sub-5 places in the ischemic lower limb for intramuscular injection consecutive 14-day.As well as control group was treated with equivalent of 0.9% sodium chloride injection,and Sub-5 places in the ischemic lower limb for intramuscular injection consecutive 14-day.Hind limbs in modeling observed immediately after surgery,7 days after surgery,14 days after surgery,28 days after surgery at different time points, changes in skin temperature and 28 days after ischemic hindlimb muscle tissue of the microvessel density.2. The patients 40 cases with the inferior genicular artery occlusive disease after transluminal angioplasty were divided randomly into the group with anisodamine (anisodamine treatment group) and the group without anisodamine (blank control group). To measure the differences between axillary temperature and ankle temperature, ankle brachial index, transcutaneous oxygen saturation, serum TC, serum TG, serum HDL-C, serum LDL-C, serum CRP and serum NO,1 day before surgery, respectively, after 1 day and after 7 days,14 days,28 days.RESULTS:1. After modeling, two groups of rats contralateral hind limbs and ischemic hind limb skin temperature difference between the gradual reduction in Small(P<0.05), And ischemia treated group compared with ischemic control group, skin temperature smaller (P<0.05), were statistically significant. The ischemia treated group compared with ischemic control group, the MVD in muscle tissue higher(P<0.05), with statistical significance.2. Postoperative, two groups of patients with ankle skin temperature were into a rising trend,and the temperature difference between axillary skin temperature and the ankle skin temperature were continuous decrease,and anisodamine treatment group than blank control group were more obvious (P<0.05),with a significant difference. The ABI of the two groups of patients were higher than preoperative, but no difference between the two groups. Percutaneous oxygen saturation of the two groups of patients were higher than preoperative,and anisodamine treatment group is more evident. Two groups of patients serum cholesterol, triglycerides, high density lipoproteins and low density lipoprotein were no significant change. The first day after surgery, the serum C-reaction protein were increased temporarily but no difference between the two groups. With the extension of treatment time the serum C-reaction protein were tended to decrease, and anisodamine treatment group is more evident. The first day after surgery, the concentration of nitric oxide were decrease temporarily, then increased, and anisodamine treatment group is more evident (P<0.05)CONCLUSIONS:1. Anisodamine can promote the establishment of collateral circulation of hind limb ischemia in rats, The mechanism may be related to anisodamine can promote some kind of angiogenine in vivo secretion or release.2. Anisodamine for inferior genicular artery occlusive disease,percutaneous transluminal angioplasty in patients with serum TG, serum TC, serum HDL-C, serum LDL-C, as well as no significant improvement in the role of ABI, but can improve the ankle skin temperature with lower limb ischemia and transcutaneous oxygen saturation, and reduce the inflammatory response and the serum CRP, and promote the secretion and release of serum NO, and improve short-term efficacy of percutaneous transluminal angioplasty and reduce restenosis rates. Its possible mechanism is by lifting the small blood vessels spasm, distending of blood vessels, promoting the establishment of collateral circulation, increasing blood flow, and improving microcirculation to achieve.