Saitta A, Bonaiuto M, Mileto A
Istituto di Medicina Interna, Università degli Studi di Messina.
Clin Ter. 1991;139(1-2):9-16.
Thirty-two patients, nineteen males and thirteen females, mean age 59.4 +/- 11.9 years, 18 with peripheral arteriopathy Fontaine stage II and 14 with cerebral vasculopathy were submitted to treatment with picotamide, 900 mg/die. In basal conditions and after 30 and 60 days of treatment, we evaluated some blood clotting parameters concerning both platelets (circulating platelet aggregates, beta-thromboglobulin, TxB2, 6-keto-pgF1 alpha) and plasma (fibrinogen, plasminogen, ATIII, Factor VIII-C and VIII Ag, prothrombin time, activated thromboplastin time) and some instrumental parameters such as walking distance and Doppler with a post-ischaemic hyperaemia test in patients with peripheral arteriopathy and Doppler of epiaortic vessels with resistance and pressure-perfusion index evaluation in patients with cerebral vasculopathy. Treatment with picotamide significantly reduced circulating platelet aggregates, beta-TG and TxB2 levels, without change of 6-keto-PGF-alpha values, with reduction of F VIII-C and slight increase of plasminogen and ATIII levels. In patients with peripheral arteriopathy after two months, a significant increase in distance and an improvement of arteriolar reactivity were observed, as shown by increase of the perfusion-index and by reduction of the post-ischaemic recovery time. These observations, together with the good tolerance of the drug, justify the use of picotamide in the treatment of patients with atherosclerotic vasculopathy at different localizations.
32例患者,19例男性,13例女性,平均年龄59.4±11.9岁,其中18例患有外周动脉病Fontaine II期,14例患有脑血管病,接受了匹可他胺治疗,剂量为900mg/天。在基础状态以及治疗30天和60天后,我们评估了一些与血小板(循环血小板聚集体、β-血小板球蛋白、TxB2、6-酮-前列腺素F1α)和血浆(纤维蛋白原、纤溶酶原、抗凝血酶III、因子VIII-C和VIII抗原、凝血酶原时间、活化部分凝血活酶时间)相关的凝血参数,以及一些仪器参数,如外周动脉病患者的步行距离和缺血后充血试验的多普勒检查,以及脑血管病患者的主动脉旁血管多普勒检查及阻力和压力灌注指数评估。匹可他胺治疗显著降低了循环血小板聚集体、β-TG和TxB2水平,6-酮-前列腺素Fα值无变化,同时因子VIII-C降低,纤溶酶原和抗凝血酶III水平略有升高。在外周动脉病患者中,两个月后观察到步行距离显著增加,小动脉反应性改善,表现为灌注指数增加和缺血后恢复时间缩短。这些观察结果,连同该药物良好的耐受性,证明了匹可他胺在治疗不同部位动脉粥样硬化血管病患者中的应用合理性。