Boobis L H, Bell P R
Br J Surg. 1982 Jun;69 Suppl:S17-23. doi: 10.1002/bjs.1800691308.
The prevalence of symptomatic arterial disease of the lower limbs is 2 per cent of the population aged 45-60, but it has a relatively benign course, with 70 per cent of patients requiring no therapy. Of the numerous drugs used in the treatment of the disease, there is no evidence to suggest that antilipaemic drugs, anticoagulants, vasodilators or rheological agents confer any benefit to the patient. The initial use of antiplatelet drugs and prostaglandins has been disappointing despite the undoubted importance of the platelet/endothelial interaction in the aetiology of atherosclerosis. As it is unlikely that we can reverse advanced disease, this is hardly surprising. Long term use of these drugs may prevent deterioration in those patients with progressive disease, and controlled trials on this aspect of treatment are now required. Symptomatic relief in the claudicant may perhaps be obtained with naftidrofuryl and suloctodil and with the former in more severe ischaemia, but their use should not replace the beneficial effects of exercise and cessation of smoking.
45至60岁人群中，有症状的下肢动脉疾病患病率为2%，但其病程相对良性，70%的患者无需治疗。在用于治疗该疾病的众多药物中，没有证据表明降脂药、抗凝剂、血管扩张剂或血液流变学药物能给患者带来任何益处。尽管血小板/内皮相互作用在动脉粥样硬化病因中无疑很重要，但抗血小板药物和前列腺素的初始应用效果并不理想。鉴于我们不太可能逆转晚期疾病，这并不奇怪。长期使用这些药物可能会防止病情进展的患者病情恶化，目前需要针对这方面治疗进行对照试验。萘呋胺酯和舒洛地尔或许能缓解间歇性跛行患者的症状，对于更严重缺血的患者，前者效果更佳，但它们的使用不应取代运动和戒烟的有益效果。
