Cabane J, Penin I, Bouslama K, Benchouieb A, Giral P, Picard O, Wattiaux M J, Cheymol G, Souvignet G, Imbert J C
Service de Médecine Interne, Hôpital Saint-Antoine, Paris.
Therapie. 1991 May-Jun;46(3):235-40.
We have treated with intravenous iloprost twelve patients suffering from cardiac insufficiency compensated under oral digoxin (NYHA class II) associated with severe limb ischaemia due to arterial insufficiency. Our aim was to study its possible interaction on digoxin levels and to evaluate the long-term efficacy of iloprost. Although iloprost slowed the digoxin absorption by approximately one hour, we found no clinically significant difference between the digoxin pharmacokinetic data before and during treatment by iloprost. Moreover, 11 out of the 12 patients had a good clinical fate after the treatment, which persisted at 6 months. The pain disappeared in 4 and diminished in 7; and all skin ulcers healed. This improvement has lasted up to two and a half years in two patients. The clinical tolerance of iloprost was acceptable despite frequent headache and flushing associated with hypotension and nausea. We conclude that iloprost seems to be a very promising treatment of severe limb ischaemia when no intervention on the proximal arteries is possible. The patients on digoxin can continue their treatment without dose alteration while starting on iloprost.
我们对12例患有口服地高辛代偿性心功能不全（纽约心脏协会II级）且因动脉供血不足伴有严重肢体缺血的患者进行了静脉注射伊洛前列素治疗。我们的目的是研究其对地高辛血药浓度可能产生的相互作用，并评估伊洛前列素的长期疗效。尽管伊洛前列素使地高辛吸收减慢了约1小时，但我们发现伊洛前列素治疗前和治疗期间地高辛的药代动力学数据在临床上无显著差异。此外，12例患者中有11例在治疗后临床转归良好，且持续至6个月。4例患者疼痛消失，7例患者疼痛减轻；所有皮肤溃疡均愈合。两名患者的这种改善持续了长达两年半。尽管伊洛前列素频繁引起头痛、面部潮红并伴有低血压和恶心，但临床耐受性尚可。我们得出结论，当无法对近端动脉进行干预时，伊洛前列素似乎是治疗严重肢体缺血非常有前景的方法。正在服用地高辛的患者在开始使用伊洛前列素时可继续其治疗且无需改变剂量。
