Department of Surgery, University of Nicosia Medical School, Nicosia, Cyprus.
Adv Ther. 2020 Feb;37(Suppl 1):19-24. doi: 10.1007/s12325-020-01219-y. Epub 2020 Jan 22.
Venous leg ulcers (VLUs) are the most severe manifestation of chronic venous disease (CVD). Due to their chronic nature, high recurrence rate and slow healing time, VLUs account for 80% of all leg ulcers seen in patients with CVD. VLUs impose a heavy burden on patients that reduces their quality of life; VLUs also represent a major socioeconomic impact due to the cost and duration of care. The primary medical approach to treating VLUs is local compression therapy in combination with venoactive drug (VAD) pharmacotherapy to promote the reduction of the inflammatory reaction initiated by venous hypertension. Micronized purified flavonoid fraction (MPFF; Daflon) is the most widely prescribed VAD. MPFF counteracts the pathophysiologic mechanisms of CVD and ulceration and has proven to be an effective adjunct to compression therapy in patients with large and chronic VLUs. Two other non-VAD drugs, pentoxifylline and sulodexide, have also been shown to improve VLU healing and are also recommended in addition to compression therapy. However, MPFF is the only VAD with the highest strength of recommendations in the 2018 guidelines for the healing of VLUs.
静脉性腿部溃疡（venous leg ulcers，VLUs）是慢性静脉疾病（chronic venous disease，CVD）最严重的表现形式。由于其慢性性质、高复发率和缓慢的愈合时间，VLUs 占 CVD 患者所有腿部溃疡的 80%。VLUs 给患者带来了沉重的负担，降低了他们的生活质量；由于护理的成本和时间，VLUs 也代表了重大的社会经济影响。治疗 VLUs 的主要医疗方法是局部压迫治疗，结合静脉活性药物（venoactive drug，VAD）药物治疗，以促进由静脉高压引发的炎症反应的减轻。微粉化纯化黄酮类混合物（micronized purified flavonoid fraction，MPFF；达肝素）是最广泛开处方的 VAD。MPFF 对抗 CVD 和溃疡的病理生理机制，已被证明是对大而慢性 VLUs 患者的压缩治疗的有效辅助手段。另外两种非 VAD 药物，己酮可可碱和舒洛地特，也已被证明能改善 VLU 的愈合，除了压缩治疗外，也被推荐使用。然而，MPFF 是 2018 年 VLUs 愈合指南中唯一具有最高推荐强度的 VAD。
