| Objective: The lower extremity arterial diseases(LEAD) is a local manifestation of systemic atherosclerosis in lower limbs, and it happened frequently in the olds. About half of LEAD patients have no obvious clinical manifestation; and 20% of patients can manifest as intermittent claudication, rest pain, limb gangrene, ischemic ulcer; the remaining 30% of the patients appear as nonspecific weakness of lower limb. The clinical manifestation can develop from intermittent claudication symptoms to rest pain, even to limb gangrene. Critical limb ischemia(critical limb ischemia, CLI) is the advanced stage of LEAD, with poor prognosis that need amputation. The fatality rate of patients accepted treatment of amputation is about 50% ~ 60% in 3-4 years. Currently, conservative treatment is the most method to LEAD Patients, such as decreasing the risk factors, exercising and medication. But drug therapy is the most important therapeutic tool. The indication of surgical operation is severe rest pain, gangrene and so on, but still need drug supportive treatment after operation. percutaneous transluminal angioplasty(PTA) has been the most usual method for LEAD, with up to 90% success rates. The most common failure reason is the restenosis after operation. So it is important to use postoperative antiplatelet, expand blood vessel, anticoagulation and thrombolysis drugs, particularly the use of postoperative antiplatelet drugs. Sarpogrelate hydrochloride is a selective blockers of 5-HT2 receptors, which can inhibit platelet aggregation, especially the function of 5-HT and fibrinogen, so as to ameliorate microcirculation disturbance and the function of erythrocyte deformation. Our study evaluate the effect of Sarpogrelate Hydrochloride to critical limb ischemia patients after operation.Methods: Randomly selecting 53 suitable inpatients from 2010 to 2013 in our hospital as experimental subject, and dividing into control group(24 cases) and experimental group(29 cases). The control group receive aspirin(100mg qd) and clopidogrel(75 mg qd) for 1 year; at the same time, the experimental group receive aspirin(100mg qd) and hydrochloric Sarpogrelate 100 mg tid. Comparison of these indicators in two groups:blood vessel patency, intermittent claudication distance(m), pain VAS(points), ankle-brachial index ABI(points), dorsal blood flow, transcutaneous oxygen partial pressure(trans cutaneous oxygen, TCPO2), inflammatory cytokines high-sensitivity C-reactive protein(hs-CRP), levels of interleukin-6(Interleukin 6, IL-6), and prothrombin time PT(S), platelet aggregation( %).Results: 1 There is no obvious difference between two groups in sex, age, and risk factors(P>0.05), 2 The patients’ condition of experimental subject get better than the control group, such as intermittent claudication distance(m), pain VAS(points), intermittent claudication distance(m)(P<0.05), 3 Indicator, such as Ankle-brachial index ABI( points), dorsal blood flow, transcutaneous oxygen pressure(trans cutaneous oxygen, TCPO2), become better in experimental subject(P<0.05), 4 The level of high-sensitivity C-inflammatory cytokines reactive protein(hs-CRP), Interleukin 6(IL-6) is lower in the experimental subject(P<0.05), but there is no obvious difference in prothrombin time PT(S) and platelet aggregation rate(%), etc.(P>0.05), 5 After 3 months comparing two group total effective rate and vascular patency rate had no difference(P>0.05); After 6 months, 12 months observation group is higher than the control group(P<0.05).Conclusion: Hydrochloride Sarpogrelate is effective to CLI, that can relieve CLI symptoms, increase walking distance, improve blood supply and so on. The combination of Sarpogrelate hydrochloride and aspirin can prevent restenosis after lower extremity endovascular treatment, effectively. |
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