Milio G, Cospite V, Cospite M
Unità Operativa Complessa di Angiologia, Azienda Ospedaliera Universitaria P. Giaccone, Università degli Studi di Palermo, Palermo, Italy.
Minerva Cardioangiol. 2003 Jun;51(3):311-6.
The purpose of the research is to determine the effects of PGE-1 in patients with chronic obliterans arteriopathy of the lower extremities and to investigate the possibility of its having an influence on local hemodynamics.
The study comprises 123 patients aged between 39 and 75 years, suffering from Fontaine's Stage Two peripheral arteriopathy randomised into 2 therapeutic groups: the patients of Group 1 were treated with PGE-1, those of Group 2 with the association pentoxyfillin-buflomedil by venous infusion. The following were evaluated: the free walking distance on a treadmill; Rest Flow, Peak Flow and basal and minimum vascular resistance by means of strain gauge plethysmography; RF, PF, tPF and tRF by means of laserdoppler.
After 4 weeks of treatment an increase of 370% was observed in the absolute free walking distance and of 260% in that relative to patients treated with PGE-1, while the increase in the same parameters in Group 2 patients was considerably lower. Further, in Group 1 patients there was a significant increase in Peak Flow and an improvement in laserdoppler parameters markedly greater than those measured in the control group.
In conclusion, the data obtained point to the effectiveness of PGE-1 in patients suffering from Fontaine's Stage 2 obliterans arteriopathy: this substance in fact improves the microcirculation and leads to the development of collateral circuits with a consequent improvement in local hemodynamics and an increase in walking distance.
本研究的目的是确定前列腺素E-1(PGE-1)对下肢慢性闭塞性动脉硬化患者的影响,并探讨其对局部血流动力学产生影响的可能性。
该研究纳入了123例年龄在39至75岁之间、患有Fontaine二期周围动脉病变的患者,随机分为2个治疗组:第1组患者接受PGE-1治疗,第2组患者接受己酮可可碱-丁咯地尔联合静脉输注治疗。评估了以下指标:跑步机上的自由行走距离;通过应变片体积描记法测量的静息血流、峰值血流以及基础和最小血管阻力;通过激光多普勒测量的RF、PF、tPF和tRF。
治疗4周后,观察到接受PGE-1治疗患者的绝对自由行走距离增加了370%,相对自由行走距离增加了260%,而第2组患者相同参数的增加幅度则低得多。此外,第1组患者的峰值血流显著增加,激光多普勒参数的改善明显大于对照组。
总之,所获得的数据表明PGE-1对患有Fontaine二期闭塞性动脉硬化的患者有效:该物质实际上改善了微循环,并导致侧支循环的形成,从而改善了局部血流动力学并增加了行走距离。