Objective To observe the effects of sarpogrelate hydrochloride in prevention and treatment for ischemia of gluteal and limb following endovascular repair of abdominal aortic aneurysm （EVAR）. Methods Clinical data were analyzed in 174 patients with abdominal aortic aneurysm （AAA） who underwent EVAR from January 2006 to January 2011. The patients’ mean age was （71.8±8.2）years old （male： 148 cases， female： 26 cases）. The diameter of abdominal aortic aneurysm was （55.2±12.9） mm. AAA involving common iliac artery was in 52 （29.9%） patients. Bifurcated endografts and aorto-uni-iliac （AUI） endografts with crossover bypass were used in 169 patients （97.1%） and 5 patients （2.9%）， respectively. Sarpogrelate hydrochloride were used in 39 patients with gluteal and limb ischemia due to exclusion of bilateral and unilateral internal iliac arteries among 174 patients. Sarpogrelate hydrochloride， 100 mg， three times daily，was taken for 2-4 weeks. Symptoms of gluteal and limb ischemia were followed-up.Results All of patients with AAA was repaired by EVAR successfully and no conversion to open repair. General anesthesia 〔50.6%（88/174）〕， epidural anesthesia 〔30.0%（52/174）〕， and local anesthesia 〔19.5%（34/174）〕 were used. Blood loss was （125.2±43.1） ml and no blood transfusion during operation. Operative time was （145.5±38.7） min, ICU stay time was （14.7±5.2） h， and postoperative fasting time was （7.2±4.3） h. The duration of postoperative hospital stay was （9.1±2.7） d. The perioperative complication rate was 12.6% （22/174）. The 30-day mortality rate was 1.1% （2/174）. Gluteal and limb claudication occurred in 2 paients and 5 patients respectively among 29 patients with EVAR due to exclusion of unilateral internal iliac artery， intermittent claudication distance was 100-200 meters. Gluteal muscle pain and limb claudication for less than 200 meters occurred in 4 patients due to exclusion of bilateral internal iliac artery. The symptoms were relieved after Sarpogrelate hydrochloride， 100 mg， three times daily， was taken for 2-4 weeks. No gluteal gangrene occurred and claudication distances were more than 500 meters when walking， no any interventional and surgical procedures were required， all of them were doing well for median 16.1 months follow-up period. Conclusions Sarpogrelate hydrochloride has definite effects on prevention and treatment for gluteal and limb ischemia following endovascular repair of abdominal aortic aneurysm，especially for exclusion of bilateral and unilateral internal iliac arteries during EVAR
Objective To evaluate the effectiveness and safety of sarpogrelate hydrochloride for patients with peripheral arterial disease (PAD). Methods The randomized controlled trials (RCTs) on PAD treated by sarpogrelate hydrochloride were identified from CBM (1978 to September 2011), CNKI (1979 to May 2011), PubMed (1950 to May 2011), EMbase (1970 to May 2011) and The Cochrane Library (Issue 3, 2011). According to the criteria of the Cochrane Handbook, two reviewers independently screened the studies, extracted and cross-checked the data, and assessed the methodological quality. Then meta-analysis was conducted by using RevMan 5.0 software. Results Nine RCTs involving 522 patients and 532 limbs were included, with low methodological quality in most trials. The results of meta-analyses indicated that compared with the conventional treatment, sarpogrelate hydrochloride could reduce the area of ulcers (MD= –3.22, 95%CI –3.99 to –2.45), and it could increase the ankle-brachial index (SMD=0.49, 95%CI 0.07 to 0.91), blood flow of dorsalis pedis artery (MD=0.16, 95%CI 0.09 to 0.23) and pain-free walking distance (MD=200.87, 95%CI 3.39 to 398.36). Five trials reported the adverse effects of sarpogrelate hydrochloride, most of which were mild gastrointestinal symptoms. Conclusion Based on the review, sarpogrelate hydrochloride may have positive effect on patients with PAD. However, the evidence is not b enough due to the general low methodological quality, so the reliable conclusion has to be drawn with more high quality studies in future.
目的 评价盐酸沙格雷酯治疗慢性下肢动脉闭塞症的有效性和安全性。方法 对根据临床症状、下肢三维血管重建（CTA）或血管造影检查诊断为慢性下肢动脉硬化闭塞症的32例患者，采用盐酸沙格雷酯（100 mg/片）治疗，1片/次，3次/d，餐后口服，连续4周。用药24个月后观察患者临床症状的改善情况，分析盐酸沙格雷酯的治疗效果。结果 用药24个月期间，失访3例，获访29例。综合疗效显效6例，良好15例，改善5例，无效3例，总有效率为89.7% （26/29）。治疗前后患者的凝血系统和临床生化各指标比较差异均无统计学意义（P＞0.05）。用药后3例（10.3%）患者出现轻度恶心和胃部不适，2例（6.9%）患者出现轻度皮疹，其余患者均无不良反应出现。安全性评价安全没问题24例，稍有问题5例。结论 盐酸沙格雷酯可以改善慢性下肢动脉硬化闭塞症患者的临床症状。
目的 总结盐酸沙格雷酯治疗周围动脉炎性疾病的初步疗效。方法 2009年10月至2012年3月期间我院共收治32例周围动脉炎性疾病患者，其中血栓闭塞性脉管炎（TAO） 18例，雷诺综合征14例，经患者知情同意的情况下给予盐酸沙格雷酯治疗，给予西络他唑100mg/d以及必须的强的松治疗后加服盐酸沙格雷酯100mg，3次/d口服，治疗后3个月观察疗效。结果 18例TAO患者中有10例服用了盐酸沙格雷酯，治疗后其间歇性跛行距离〔（362±127） m〕较治疗前 〔（224±86） m〕延长；8例静息痛患者中7例症状消失，1例改善；4例溃疡患者中3例愈合，1例未愈合。8例未加服盐酸沙格雷酯患者，有6例间歇性跛行消失，2例改善；5例静息痛患者中3例症状消失，2例改善；2例溃疡患者中1例愈合，1例未愈合。14例雷诺综合征患者中8例加服盐酸沙格雷酯，雷诺症状7例消失，1例改善；3例溃疡患者完全愈合。6例未加服盐酸沙格雷酯患者雷诺症状4例消失，2例改善；1例溃疡患者未愈合。结论 从本组有限病例资料看，盐酸沙格雷酯对于治疗周围动脉炎性疾病是有效的。
目的观察盐酸沙格雷酯治疗血栓闭塞性脉管炎的近期疗效。 方法回顾性分析笔者所在医院2009年7月至2012年7月期间采用盐酸沙格雷酯治疗的28例血栓闭塞性脉管炎患者的临床资料，比较服药前后患者间歇性跛行距离、静息痛评分、冷感评分及溃疡面积的差异。 结果用药4周后，患者的无痛跛行距离〔（287±32）m比（167±28）m〕和最长跛行距离〔（315±40）m比（187±34）m〕延长，静息痛得分（1分比2分）和冷感得分（1分比2分）降低，溃疡面积缩小〔（6.18±3.28）cm2比（10.06±4.25）cm2〕，差异均具有统计学意义（P<0.05）。 结论盐酸沙格雷酯能改善血栓闭塞性脉管炎的缺血症状。
目的探讨盐酸沙格雷酯治疗2型糖尿病合并下肢动脉硬化闭塞症（ASO）患者的临床疗效。 方法笔者所在医院科室2011年2月至2012年2月期间采用盐酸沙格雷酯治疗了64例2型糖尿病合并ASO住院患者，用药方法为100 mg/次，3次/d，连续用药3个月。比较患者用药前后临床症状与体征、踝肱指数（ABI）、足背动脉血流量、凝血功能等指标的变化。 结果治疗后患者主观感觉下肢麻木、冷感、疼痛等症状均有不同程度的改善；间歇性跛行距离〔（620.26±16.76）m比（236.28±18.43）m〕、ABI〔0.86±0.04比0.50±0.08〕及足背动脉血流量〔（32.5±16.8）mL/min比（21.1±10.2）mL/min〕均较治疗前好转（P<0.05）；空腹血糖〔（6.18±1.23）mmol/L比（8.32±1.58）mmol/L〕、糖化血红蛋白〔（6.88±0.45）%比（7.26±0.26）%〕及低密度脂蛋白〔（3.02±0.26）mmol/L比（3.31±0.30）mmol/L〕也明显改善（P<0.05）；而治疗前后的凝血酶原时间、血小板计数、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、肌酐及尿素氮的差异均无统计学意义（P>0.05）。综合疗效显著24例，有效38例，无效2例，总有效率为96.9%。用药后有3例患者出现轻度胃部不适症状，余无任何不良反应及药物过敏发生。 结论盐酸沙格雷酯在2型糖尿病合并ASO患者的临床治疗中安全有效。
ObjectiveTo investigate the clinical efficacy of sarpogrelate hydrochloride in preventing restenosis after femoral artery stent implantation. MethodsTwo hundreds and fifty-one cases of ischemic disease of lower extremity (286 affected limbs in total) who got treatment in our hospital were collected, and were divided into prevention group(125 cases with 146 affected limbs) and control group(126 cases with 140 affected limbs) according kinds of medicine. At the basement of medicine in control group, cases of prevention group got treatment of sarpogrelate hydrochloride in addition. Comparison of related indexed was performed by SPSS 17.0 software. ResultsCompared with before treatment in prevention group, only foot skin ulcer and gangrene score decreased(P<0.05), and there were no significant difference on other indexes included visual anafogue scales(VAS), intermittent claudication distance score, ankle brachial index (ABI), and vascular stenosis score(P>0.05). But in control group, compared with before treatment, foot skin ulcer and gangrene score and ABI value decreased(P<0.05), the VAS score, intermittent claudication distance score, and vascular stenosis score increased(P<0.05). There were significant difference on the difference between after treatment and before treatment of all 5 indexes(P<0.05), that the changed value of foot skin ulcer and gangrene score was higher in prevention group, but lower on other 4 indexes. There were no untoward effect happened during treatment. ConclusionClinical effect of sarpogrelate hydrochloride in the prevention of restenosis of the femoral artery after stent implantation was significantly, and it can keep related indexes stable.