Shechter M, Agranat O, Har-Zahav Y, Rath S, Kaplinsky E, Rabinowitz B
The Heart Institute, Sheba Medical Center, Tel-Hashomer, Israel.
Am J Ther. 1997 Nov-Dec;4(11-12):395-400. doi: 10.1097/00045391-199711000-00009.
The effect of intravenous prostaglandin E ( 1 ) (PGE ( 1 ) ) on the incidence of restenosis after elective percutaneous transluminal coronary angioplasty (PTCA) was studied in a prospective, single-blind, randomized trial of 30 patients. Group I (12 patients) received only the conventional medications before and after protocol, and group II (18 patients) received intravenous PGE ( 1 ) infusion for 24 hours starting at least 2 hours before angiography after hemodynamically based titration to a mean dosage of 16 +/- 3 ng/kg/min (range, 10-20 ng/kg/min). All patients received aspirin orally, beginning 24 hours before PTCA and continuing for 6 months, and intravenous heparin at 1000 U/h for 24 hours commencing with the beginning of catheterization before PTCA. Recatheterization was performed routinely at 6 months after PTCA, or earlier when clinically indicated. Angiographic evaluations were made by both visual and quantitative assessment. No significant side effects of PGE ( 1 ) treatment were observed. Only 17% of patients treated by PGE ( 1 ) experienced angina pectoris during 6-month follow-up period, as compared with 42% of patients who received conventional treatment (p = 0.13). Re-PTCA was more frequent in patients receiving conventional therapy than in those receiving PGE ( 1 ) (42% versus 11%; p = 0.06). The use of PGE ( 1 ) during PTCA was associated with 17% restenosis (both by computer and by visual evaluation) 6 months post-PTCA as compared with 33% and 50% restenosis (by computer and by visual evaluations, respectively) in the conventional group (p < 0.05). In conclusion, PGE ( 1 ) appears to decrease coronary restenosis 6 months after PTCA.
在一项针对30例患者的前瞻性、单盲、随机试验中，研究了静脉注射前列腺素E（1）（PGE（1））对择期经皮腔内冠状动脉成形术（PTCA）后再狭窄发生率的影响。第一组（12例患者）在方案前后仅接受常规药物治疗，第二组（18例患者）在基于血流动力学滴定至平均剂量16±3 ng/kg/min（范围为10 - 20 ng/kg/min）后，于血管造影前至少2小时开始静脉输注PGE（1）24小时。所有患者在PTCA前24小时开始口服阿司匹林，并持续6个月，在PTCA前开始导管插入时开始静脉注射肝素1000 U/h，持续24小时。PTCA后6个月常规进行再次导管插入术，或在临床指征时提前进行。通过视觉和定量评估进行血管造影评估。未观察到PGE（1）治疗的明显副作用。在6个月的随访期内，接受PGE（1）治疗的患者中只有17%出现心绞痛，而接受常规治疗的患者为42%（p = 0.13）。接受常规治疗的患者再次PTCA比接受PGE（1）治疗的患者更频繁（42%对11%；p = 0.06）。与常规组中分别为33%和50%的再狭窄（通过计算机和视觉评估）相比，PTCA期间使用PGE（1）与PTCA后6个月17%的再狭窄相关（通过计算机和视觉评估）（p < 0.05）。总之，PGE（1）似乎可降低PTCA后6个月的冠状动脉再狭窄。
