Tsukanov Yu T, Nikolaichuk A I
Chair of Surgical Diseases and Urology, Omsk State Medical University, Omsk, Russia.
Angiol Sosud Khir. 2016;22(2):110-6.
The authors carried out a study aimed at revealing transitory refluxes along the great saphenous vein (GSV) in patients with intracutaneous varicosity, and at investigating the possibility of removing them by means of preparations of micronized purified flavonoid fraction (MPFF). The study included a total of one hundred and forty-seven 21-to-47-year-old (mean age 31±4.4 years) women presenting with cutaneous varicosity (class C1s). The duration of skin manifestations amounted to 9.4±3.9 years (varying from 4 to 24 years). Telangiectasias were present in 69 (46.9%) women, 36 (24.5%) women had reticular varicosity, and 42 (28.6%) a combination thereof. An author-devised test was used with prolonged orthostatic load consisting in carrying ultrasound duplex scanning twice: in the evening after 6 p. m. and in the morning before 10 a.m., assessing the evening and morning parameters of the GSV, as well as the increment of the diameter of the vein at evening measurement as compared with the morning indices. Women with transitory refluxes along the GSV (n=59) underwent treatment with MPFF preparations (Detralex, Servier) during 60 days at a daily dose of 1,000 mg. The morning examination showed that there was no reflux along the GSV. The evening examination revealed refluxes along the GSV of various pattern and extent in 59 (40.1 %). All the 59 patients with evening refluxes presented complaints for increased fatigability, heaviness in the lower limbs by the end of the day. After 2 months of treatment, of the 59 women with initial reflux, 38 (64.4%) patients had no reflux and in 21 (35.6%) the extent of reflux decreased more than twofold. The evening diameter of the GSV decreased from 5.7 mm (95% CI 4.0-7.1) to 5.2 mm (95% CI 5.5-6.5) and the orthostatic gradient decreased from 0.9 mm (95% CD 0.6-1.3) to 0.6 mm (95% CI 0.4-0.8), p=0.000001. The initial complaints for heaviness in the legs after treatment disappeared in 76.6% of patients (50 of 59 subjects); in 9 women intensity of complaints decreased. The quality of life index decreased from 42 (95% CI 28-55) to 31 (95% CI 15-52) points (p=00001). Conclusions were drawn that in intracutaneous reflux in 40.1% of cases there appear transitory evening refluxes along the GSV revealed in the day-time orthostatic test. Taking MPFFs at a dose of 1,000 mg daily during 2 months removes evening transitory reflexes in 64.4% of cases and in 35.6% of cases decrease them, thus promoting contributing to decreased intensity of venous complaints and an increase in quality of life.
作者开展了一项研究，旨在揭示患有皮内静脉曲张的患者大隐静脉（GSV）的短暂反流情况，并研究通过微粉化纯化黄酮类成分（MPFF）制剂消除这些反流的可能性。该研究共纳入了147名年龄在21至47岁（平均年龄31±4.4岁）的患有皮肤静脉曲张（C1s级）的女性。皮肤表现的持续时间为9.4±3.9年（4至24年不等）。69名（46.9%）女性有毛细血管扩张，36名（24.5%）女性有网状静脉曲张，42名（28.6%）女性两者皆有。采用作者设计的测试方法，施加长时间的直立负荷，包括进行两次超声双功扫描：一次在晚上6点后，一次在上午10点前，评估GSV的夜间和早晨参数，以及与早晨指标相比夜间测量时静脉直径的增量。GSV有短暂反流的女性（n = 59）接受MPFF制剂（地奥司明，施维雅）治疗60天，每日剂量为1000毫克。早晨检查显示GSV无反流。夜间检查发现59名（40.1%）患者的GSV出现了不同模式和程度的反流。所有59名夜间有反流的患者均主诉在一天结束时疲劳感增加、下肢沉重。治疗2个月后，最初有反流的59名女性中，38名（64.4%）患者无反流，21名（35.6%）患者反流程度降低超过两倍。GSV的夜间直径从5.7毫米（95%可信区间4.0 - 7.1）降至5.2毫米（95%可信区间5.5 - 6.5），直立梯度从0.9毫米（95%可信区间0.6 - 1.3）降至0.6毫米（95%可信区间0.4 - 0.8），p = 0.000001。治疗后最初腿部沉重的主诉在76.6%的患者（59名受试者中的50名）中消失；9名女性的主诉强度减轻。生活质量指数从42分（95%可信区间28 - 55）降至31分（95%可信区间15 - 52）（p = 0.0001）。得出的结论是，在皮内反流中，40.1%的病例在日间直立试验中显示GSV出现短暂的夜间反流。在2个月内每日服用1000毫克MPFF可使64.4%的病例消除夜间短暂反流，35.6%的病例反流减少，从而有助于减轻静脉主诉的强度并提高生活质量。
