Comparative Study Of Sarpogrelate Hydrochloride And Cilostazol In Patients With Lower Limb Arteriosclerosis Obliterans After Percutaneous Transluminal Angioplasty

Objective:Lower limb atherosclerosis occlusion disorder（Atherosclerotic obliterans ASO）is left lower limb muscle ischemia hypoxia of atherosclerosis lead to intermittent claudication,typical performance for muscle pain,cramps or calf,hip or heel of numbness,movement and induced when walking,can alleviate after the break.The current conservative treatment to control the risk factors:positive body exercise and medication and so forth.If patients with severe resting pain or limb gangrene,surgical intervention to become effective measures to save the body even the life.Treatment mainly include:through surgery and（or）intracavitary treatment rebuild blood flow way,now think that blood vessel revascularization is the best solution for the treatment of severe ischemia lower limb.Postoperative use of antiplatelet,vasodilator,anticoagulant and thrombolytic drugs can effectively avoid the adverse consequences of restenosis after revascularization.Especially in antiplatelet therapy.In this study,two antiplatelet drugs,5-HT₂ receptor antagonist（sarpogrelate hydrochloride）and cilostazol（phosphodiesterase inhibitor）,were selected as therapeutic drugs.To compare the efficacy and safety of interventional surgery in patients with lower extremity arteriosclerosis obliterans.Methods:patients underwent interventional therapy of lower extremity vessels in our department from June 2017 to December 2017,A randomized,parallel controlled clinical trial was used.The patients were divided into two groups:aspirin sarpogrelate hydrochloride group（trial group）and aspirin cilostazol group（control group）.On the basis of routine treatment,both groups were given aspirin enteric-coated tablets 100mg po QD.The trialgroup was treated with Sarpogrelate hydrochlorid（100mg po TID）and the control groupwith cilostazol（100mg po BID）.After 12 weeks of continuous administration,the laboratory indexes（white blood cell count,red blood cell count,platelet count,fasting blood glucose,low density lipoprotein,alanine transaminase,serum creatinine,prothrombin time,plasma fibrinogen,etc.）were observed.The symptoms of lower extremity vascular lesion and neuropathy before and after treatment;Pain VAS score;the distance of painless walking;the maximum walking distance that can tolerate pain;Ankle-Brachial Index（ABI）;Cardiovascular events（myocardial infarction,stroke or pulmonary embolism）,clinical bleeding rate and adverse drug reactions were observed in both groups.Results:1.The final effective cases were 44 patients,21 patients in the trial group and23 in the control group.Except for one patient amputation one month after operation in the trial group,the other cases were all randomly shed.There was no significant difference in sex,age and complications between the two groups（P>0.05）.2.The improvement rate of pain symptoms in the trial group was significantly higher than that in the control group（56.5%）.The changes of white blood cell,erythrocyte count,alanine aminotransferase,serum creatinine and fasting blood glucose were not affected in both groups（P>0.05）.The changes of low density lipoprotein（LDL-C）in the trial group were statistically significant at 12 weeks and 1 week postoperatively.The change of fibrinogen in the control group was significantly different from that in the control group at 12 weeks and 1 week after operation.Both groups could prolong prothrombin time（P<0.05）.Improvement of claudication distance in experimental group compared with control group P<0.05.Both groups could increase the ABI value（P<0.05）.3.In the control group,1 case of patients bleeding events（2.3%）.Other cases had no adverse effects of bleeding,gastrointestinal discomfort,liver and kidney dysfunction and abnormal coagulation function.Conclusions:1.It is safe to treat lower extremity ASO with sarpogrelate hydrochloride or cilostazol combined with aspirin.2.Sarpogrelate hydrochloride or cilostazol combined with aspirin.treatment of lower limb arteriosclerosis occlusion can effectively improve the blood supply of the ischemia,relieve patients symptoms such as numbness,pain,fear cold,increase the maximum walking distance and maximum distance walking painful.3.sarpogrelate hydrochloride combined with aspirin in improving pain,claudication distance increases significantly.No significant differences in terms of ABI values increase.