Milio G, Corrado E, Genova C, Amato C, Raimondi F, Almasio P L, Novo S
Department of Internal Medicine and Cardiovascular Diseases, University of Palermo, Palermo, Italy.
Rheumatology (Oxford). 2006 Aug;45(8):999-1004. doi: 10.1093/rheumatology/kel038. Epub 2006 Feb 16.
To evaluate the clinical efficacy and the effects on the quality of life of iloprost, a prostacyclin analogue, used according to a new protocol in patients with Raynaud's phenomenon secondary to systemic sclerosis.
In this randomized study, we treated 30 patients with iloprost, given by intravenous infusion, at progressively increasing doses (from 0.5 to 2 ng/kg/min) over a period of 6 h each day for 10 days in two consecutive weeks, with repeated cycles at regular intervals of 3 months for 18 months. The results were compared with those obtained in 30 other patients who received the same drug but with different dosing schemes.
The total average daily duration of the attacks, the average duration of a single attack and the average daily frequency of the attacks were reduced significantly in all treatment groups, but the comparison between the groups demonstrated significant differences between patients treated with the new protocol and the others at later times (12 and 18 months). The effects on the quality of life in the group treated with the new protocol, evaluated with the Short Form-36, demonstrated a marked improvement regarding both the scale relating to the physical aspect of the illness and, especially, the scale relating to the mental aspect.
In patients with systemic sclerosis, cyclic intravenous iloprost infusion is efficacious in the treatment of Raynaud's phenomenon. The protocol that we used, compared with others, not only has favourable clinical effects but also leads to a marked improvement in the quality of life.
评估依洛前列素（一种前列环素类似物）按照新方案用于系统性硬化症继发雷诺现象患者时的临床疗效及其对生活质量的影响。
在这项随机研究中，我们对30例患者使用依洛前列素进行治疗，通过静脉输注，每天6小时内剂量逐渐增加（从0.5至2纳克/千克/分钟），持续10天，连续两周，之后每3个月定期重复一个周期，共进行18个月。将结果与另外30例接受相同药物但给药方案不同的患者所获得的结果进行比较。
所有治疗组的发作总平均每日时长、单次发作平均时长和发作平均每日频率均显著降低，但组间比较显示，采用新方案治疗的患者与其他患者在后期（12个月和18个月）存在显著差异。采用新方案治疗的组，通过简短健康调查问卷-36评估的生活质量方面，在与疾病身体方面相关的量表，尤其是与精神方面相关的量表上均显示出明显改善。
在系统性硬化症患者中，周期性静脉输注依洛前列素对雷诺现象有效。我们采用的方案与其他方案相比，不仅具有良好的临床效果，还能显著改善生活质量。
