Cabane J, Bouslama K, Giral P, Benchouieb A, Picard O, Lebas J, Wattiaux M J, Penin I, Souvignet G, Imbert J C
Service de Médecine Interne, Hôpital Saint-Antoine, Paris.
Rev Med Interne. 1991 Nov-Dec;12(6):465-70. doi: 10.1016/s0248-8663(05)83198-4.
Twelve patients with critical ischaemia of the lower limbs were treated with iloprost. The purpose of this study was to investigate for a possible iloprost-digoxin interaction and to evaluate the clinical benefit provided by short- or long-term iloprost therapy. The pharmacokinetics of digoxin were studied before and during iloprost treatment. Under iloprost the absorption of digoxin was delayed by about one hour, but the area under the plasma digoxin concentration curve remained unmodified. In 11 of our 12 patients the clinical effect of iloprost was satisfactory both immediately and after 6 months. Pain vanished in 6 patients and diminished in 6 patients. All skin ulcers were healed. In most cases this improvement persisted beyond the study period: 2 patients treated at the beginning of the study and who are still followed up have remained improved after 2 1/2 years. Two patients with pain relapse received iloprost in repeated 10 days' courses with successful results. The treatment was relatively well tolerated (headaches, flushing, abdominal pain). Thus, iloprost can avoid amputation in severe arteritis unsuitable for revascularization and for which there is no effective treatment. Patients under digoxin may continue to take this drug in the same doses during treatment with iloprost.
12例下肢严重缺血患者接受了伊洛前列素治疗。本研究的目的是调查伊洛前列素与地高辛之间可能的相互作用，并评估短期或长期伊洛前列素治疗所带来的临床益处。在伊洛前列素治疗前及治疗期间研究了地高辛的药代动力学。在伊洛前列素作用下，地高辛的吸收延迟约1小时，但血浆地高辛浓度曲线下面积保持不变。在我们的12例患者中，11例患者在即刻及6个月后伊洛前列素的临床效果均令人满意。6例患者疼痛消失，6例患者疼痛减轻。所有皮肤溃疡均愈合。在大多数情况下，这种改善在研究期后仍持续存在：在研究开始时接受治疗且仍在随访的2例患者在2年半后仍保持改善。2例疼痛复发的患者接受了为期10天的重复伊洛前列素疗程治疗，结果成功。该治疗耐受性相对良好（头痛、潮红、腹痛）。因此，伊洛前列素可避免在不适于血管重建且无有效治疗方法的严重动脉炎中进行截肢。正在服用地高辛的患者在接受伊洛前列素治疗期间可继续按相同剂量服用该药物。
