Melillo Elio, Grigoratos Chrysanthos, Sanctis Francesco De, Spontoni Paolo, Nuti Marco, Dell'Omodarme Matteo, Ferrari Mauro, Balbarini Alberto
Angiology Division, Cardiothoracic and Vascular Department, University of Pisa, Pisa, Italy.
Angiology Division, Cardiothoracic and Vascular Department, University of Pisa, Pisa, Italy
Angiology. 2015 Jul;66(6):531-8. doi: 10.1177/0003319714541800. Epub 2014 Jul 8.
We evaluated the effectiveness of intravenous iloprost (IVI) in outpatients with thromboangiitis obliterans (TAO) and lower limb noninvasive transcutaneous monitoring (TCM) at follow-up (FU). Ten consecutive patients with TAO underwent IVI therapy. Transcutaneous oxygen (TcPo 2) and carbon dioxide (TcPco 2) determination and laser Doppler flowmetry (LDF) were performed before and after IVI at 3, 6, and 12 months of FU. Clinical response was positive in 7 patients, whereas 3 nonresponders underwent a second IVI cycle with 1 showing a late positive clinical response. After 12 months of FU, all patients were alive without amputations. Supine and dependent TcP2 levels significantly improved (P < .005). Hallux LDF values showed significant change with the maximal hyperemic test at 44°C (P < .005). Forefoot maximal hyperemic test at 44°C LDF (P < .005) and improved venous arterial reflex (P < .05) showed statistically significant time evolution. We demonstrated some degree of IVI effectiveness and evaluated TCM in patients with TAO.
我们评估了静脉输注伊洛前列素（IVI）对血栓闭塞性脉管炎（TAO）门诊患者的疗效，以及随访（FU）期间下肢无创经皮监测（TCM）情况。连续10例TAO患者接受IVI治疗。在FU的3、6和12个月时，于IVI治疗前后进行经皮氧分压（TcPo₂）和二氧化碳分压（TcPco₂）测定以及激光多普勒血流仪（LDF）检查。7例患者临床反应为阳性，而3例无反应者接受了第二个IVI疗程，其中1例出现延迟阳性临床反应。FU 12个月后，所有患者均存活且未行截肢手术。仰卧位和站立位时的TcP₂水平显著改善（P < .005）。拇趾LDF值在44°C最大充血试验时显示出显著变化（P < .005）。前足在44°C最大充血试验时的LDF（P < .005）以及改善的静脉动脉反射（P < .05）显示出具有统计学意义的时间演变。我们证明了IVI有一定程度的疗效，并对TAO患者进行了TCM评估。
