过敏性紫癜患者银杏达莫注射液治疗前后血管内皮功能、凝血功能的变化及相关性研究

摘要 目的：探讨过敏性紫癜（HSP）患者银杏达莫注射液治疗前后血管内皮功能、凝血功能的变化，并分析HSP患者血管内皮功能与凝血功能的相关性。方法：选择2018年2月至2020年2月期间我院收治的HSP患者93例，按照随机数字表法将患者分为对照组（n=46）和观察组（n=47），其中对照组给予糖皮质激素治疗，观察组给予银杏达莫注射液治疗，对比两组疗效、血管内皮功能、凝血功能的变化及紫癜性肾炎的发生率，并分析HSP患者血管内皮功能与凝血功能的相关性。结果：观察组治疗2周后的总有效率95.74%（45/47），较对照组的76.09%（35/46）升高（P<0.05）。两组患者治疗2周后血清血管内皮生长因子（VEGF）、内皮素-1（ET-1）水平均降低，且观察组低于对照组（P<0.05）。两组患者治疗2周后纤维蛋白原（FIB）、D-二聚体（D-D）、血小板计数（PLT）均降低，且观察组低于对照组（P<0.05），凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）均升高，且观察组高于对照组（P<0.05）。两组紫癜性肾炎发生率对比无统计学差异（P>0.05）。观察组患者中VEGF、ET-1均与FIB、D-D、PLT呈正相关，而与PT、APPT、TT呈负相关（P<0.05）。结论：HSP的发病过程中存在血管内皮细胞损伤及血液高凝状态，采用银杏达莫注射液治疗HSP患者，疗效显著，可有效改善患者血管内皮功能、凝血功能，且血管内皮功能与凝血功能存在一定的相关性。

Changes and Correlation Study of Vascular Endothelial Function and Coagulation Function in Patients with Henoch Schonlein Purpura before and after Treatment with Ginkgo Biloba and Dipyridamole Injection

ABSTRACT Objective: To investigate the changes of vascular endothelial function and coagulation function in patients with Henoch Schonlein purpura (HSP) before and after treatment with Ginkgo biloba and dipyridamole injection, and to analyze the correlation between vascular endothelial function and coagulation function in patients with HSP. Methods: 93 cases of patients with HSP in our hospital from February 2018 to February 202 were selected, and randomly divided into control group (n=46) and observation group (n=47) according to the random number table method. The control group was given glucocorticoid treatment, and the observation group was given Ginkgo biloba and dipyridamole injection. The curative effect, vascular endothelial function, coagulation function and the incidence rate of anaphylatic purpura nephritis were compared between the two groups. The correlation between vascular endothelial function and coagulation function in patients with HSP was analyzed. Results: 2 weeks after treatment, the total effective rate of the observation group was 95.74%(45/47), which was higher than 76.09%(35/46) of the control group (P<0.05). 2 weeks after treatment, the levels of serum vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) in the two groups were decreased, and the observation group was lower than the control group (P<0.05). 2 weeks after treatment, fibrinogen (FIB), D-Dimer (D-D), platelet count (PLT) in the two groups were decreased, and the observation group was lower than the control group (P<0.05), prothrombin time(PT), activated partial thromboplastin time (APTT), thrombin time (TT) were increased, and the observation group was higher than the control group (P<0.05). There was no difference in the incidence rate of anaphylatic purpura nephritis between the two groups (P>0.05). In the observation group, VEGF and ET-1 were positively correlated with FIB, D-D and PLT, but negatively correlated with PT, APPT and TT(P<0.05). Conclusion: There are vascular endothelial cell damage and hypercoagulable state in the pathogenesis of HSP. Ginkgo biloba and dipyridamole injection is effective in the treatment of patients with HSP, which can effectively improve the vascular endothelial function and coagulation function, and there is a correlation between vascular endothelial function and coagulation function.