Matsumoto T, Iwasa K, Kyuragi R, Honma K, Guntani A, Ohmine T, Itoh H, Onohara T, Maehara Y
Department of Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Int Angiol. 2010 Apr;29(2 Suppl):49-54.
This study aimed to evaluate the effect of oral beraprost sodium, a prostaglandin I2 analogue, on symptoms of intermittent claudication in patients with arteriosclerosis obliterans. The research design consisted of a before and after treatment study without comparison groups. The subjects comprised arteriosclerosis obliterans patients who experienced intermittent claudication. Furthermore, this study aimed to assess the mechanism of action of beraprost sodium via blood sampling and measurements of flow-mediated vasodilatation before and after treatment.
The study was performed prospectively in 7 patients with arteriosclerosis obliterans. Beraprost sodium (40 microg) was orally administered to 7 patients at study entry, followed by administration of 120 microg/day for 12 weeks. Blood sampling and measurements of flow-mediated vasodilatation were performed before and after treatment at study entry, 4 weeks, and 12 weeks after treatment. Treadmill exercise tests were performed three times at study entry, 4 weeks, and 12 weeks after treatment. The ankle-brachial index (ABI) was measured at rest and after exercise.
Pain-free walking distances increased by 138% at 12 weeks after treatment. Maximum walking distances increased by 133%. The ABI was significantly increased at 4 weeks and 12 weeks after treatment at rest. Endothelin-1 levels tended to be decreased at 1 h after administration of 40 microg beraprost sodium. N(G),N(G)-dimethyl-L-arginine, nitrate ions, and flow-mediated vasodilatation.
Beraprost sodium tended to decrease endothelin-1 levels and improved symptoms of intermittent claudication in patients with arteriosclerosis obliterans.
本研究旨在评估前列环素I2类似物口服贝前列素钠对闭塞性动脉硬化症患者间歇性跛行症状的影响。研究设计为无对照组的治疗前后研究。研究对象为患有间歇性跛行的闭塞性动脉硬化症患者。此外,本研究旨在通过治疗前后的血液采样和血流介导的血管舒张测量来评估贝前列素钠的作用机制。
对7例闭塞性动脉硬化症患者进行前瞻性研究。7例患者在研究开始时口服贝前列素钠(40微克),随后以每日120微克的剂量给药12周。在研究开始时、治疗后4周和12周进行治疗前后的血液采样和血流介导的血管舒张测量。在研究开始时、治疗后4周和12周进行三次跑步机运动试验。在休息时和运动后测量踝臂指数(ABI)。
治疗12周后无痛步行距离增加了138%。最大步行距离增加了133%。治疗后4周和12周休息时ABI显著升高。给予40微克贝前列素钠1小时后内皮素-1水平趋于下降。N(G),N(G)-二甲基-L-精氨酸、硝酸根离子和血流介导的血管舒张。
贝前列素钠倾向于降低内皮素-1水平,并改善闭塞性动脉硬化症患者的间歇性跛行症状。