Gossetti B, Antignani P L, Jabbour J, Martinelli O
Vascular Surgery and Emergency Vascular Surgery Division, Azienda Policlinico Umberto I, Rome, Italy.
Int Angiol. 2015 Aug;34(4):398-406. Epub 2015 May 14.
Mesoglycan, composed of natural glycosaminoglycans, is used for treatment in arterial and venous disease for its benefits on endothelial glicocalix. Little is known about mesoglycan impact on endothelial blood flow regulation. We sought to evaluate the effects of mesoglycan intermittently added to back-ground treatments on impairment of endothelial function in peripheral arterial disease (PAD) patients.
We studied the effects of a 2+2 months oral treatment with 50 mg b.i.d. of mesoglycan, intervalled by 2 months without mesoglycan, in 540 PAD patients on four occasions (visit 1: baseline, visit 2: 2 months, visit 3: 4 months and visit 4: 6 months). At these time visits we assessed brachial artery endothelial-dependent flow-mediated dilation (FMD), together with femoral intima-medial thickness (IMT), and walking distance (WD).
There were significant changes in FMD (1.88%, CI 95%: 1.13, 2.63; P<0.001), IMT (-0.05 mm, CI 95%: -0.07,-0.02; P<0.001) and WD (38,9%, CI 95% 33.2, 44.8; P<0.001). The positive effects and benefit were maintained during the two-months interval without mesoglycan treatment. Significant changes in FMD were observed in a number of patient groups, stratified for risk factors (aging, sex, smoke, diabetes, dyslipidemia, hypertension).
Two months cycles with mesoglycan improved endothelial function in PAD patients, with a parallel reduction of atherosclerotic damage and amelioration of clinical condition.
由天然糖胺聚糖组成的硫酸皮肤素，因其对内皮糖萼的益处而用于动脉和静脉疾病的治疗。关于硫酸皮肤素对内皮血流调节的影响知之甚少。我们试图评估间歇性添加硫酸皮肤素至背景治疗对周围动脉疾病（PAD）患者内皮功能损害的影响。
我们研究了540例PAD患者接受为期2 + 2个月、每日两次、每次50 mg硫酸皮肤素的口服治疗，中间间隔2个月不服用硫酸皮肤素，共进行四个阶段（访视1：基线，访视2：2个月，访视3：4个月，访视4：6个月）。在这些访视时间，我们评估肱动脉内皮依赖性血流介导的舒张功能（FMD）、股动脉内膜中层厚度（IMT）和步行距离（WD）。
FMD（1.88%，95%置信区间：1.13，2.63；P<0.001）、IMT（-0.05 mm，95%置信区间：-0.07，-0.02；P<0.001）和WD（38.9%，95%置信区间33.2，44.8；P<0.001）有显著变化。在不进行硫酸皮肤素治疗的两个月间隔期间，积极效果和益处得以维持。在按危险因素（年龄、性别、吸烟、糖尿病、血脂异常、高血压）分层的多个患者组中观察到FMD有显著变化。
硫酸皮肤素治疗两个月周期可改善PAD患者的内皮功能，同时并行减少动脉粥样硬化损伤并改善临床状况。
