Gaillard-Bigot Florence, Roustit Matthieu, Blaise Sophie, Cracowski Claire, Seinturier Christophe, Imbert Bernard, Carpentier Patrick, Cracowski Jean-Luc
University Grenoble Alpes, Grenoble, France.
Clinical Pharmacology Unit, INSERM CIC1406, Grenoble University Hospital, Grenoble, France.
Microcirculation. 2016 Apr;23(3):266-70. doi: 10.1111/micc.12272.
Severe Raynaud's syndrome and DUs are the most prevalent manifestations of SSc peripheral microvascular disease. We tested whether treprostinil iontophoresis on the finger pad of patients with SSc would improve digital blood flow during hand cooling.
Eleven patients with limited cutaneous SSc underwent a double-blinded iontophoresis of treprostinil (2.56 × 10(-4) M during two hours) and placebo (NaCl 0.9%) on two finger pads. Then, the hand was inserted for 30 minutes in a fenestrated cooling box at 8 °C, and skin blood flow was recorded continuously using LSCI.
During the local cooling, CVC was significantly higher at the treprostinil site than at the placebo site and remained higher 30 minutes after the test.
In patients with SSc, digital treprostinil iontophoresis shifts skin blood flow upward during local cooling of the hand and during the initial rewarming phase. Digital treprostinil iontophoresis should now be tested in larger scale studies.
严重雷诺综合征和指端溃疡是系统性硬化症外周微血管疾病最常见的表现。我们测试了系统性硬化症患者指腹的曲前列尼尔离子导入是否会在手部冷却期间改善指端血流。
11例局限性皮肤型系统性硬化症患者在两个指腹接受了曲前列尼尔（2.56×10⁻⁴M，持续两小时）和安慰剂（0.9%氯化钠）的双盲离子导入。然后，将手放入8℃的带孔冷却箱中30分钟，使用激光散斑对比成像连续记录皮肤血流。
在局部冷却期间，曲前列尼尔部位的皮肤血管传导率显著高于安慰剂部位，且在测试后30分钟仍保持较高水平。
在系统性硬化症患者中，指腹曲前列尼尔离子导入在手部局部冷却和初始复温阶段会使皮肤血流向上转移。现在应该在更大规模的研究中测试指腹曲前列尼尔离子导入。
