Palmieri G M, Sebes J I, Aelion J A, Moinuddin M, Ray M W, Wood G C, Leventhal M R
University of Tennessee at Memphis 38163, USA.
Arthritis Rheum. 1995 Nov;38(11):1646-54. doi: 10.1002/art.1780381117.
To test the hypothesis that the calcium antagonist diltiazem is effective in the treatment of calcinosis.
Diltiazem, 240-480 mg/day, was given to 4 patients with idiopathic or CREST-related (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias) calcinosis for 1-12 years. Serial radiographs of the affected areas, using identical technique, and clinical evaluations were obtained. A fifth patient, who did not tolerate diltiazem, received verapamil, 120 mg/day for 18 months.
All patients taking diltiazem had a reduction or disappearance of the calcific lesions, with striking clinical improvement. One patient's case was followed for 12 years. The response to diltiazem during the first 5 years of treatment has been previously reported in detail; however, over 7 years of additional treatment, there was further reduction of the lesions. One patient developed a large calcific lesion while receiving verapamil for hypertension, and after verapamil was replaced with diltiazem, there was a dramatic response. Verapamil was ineffective in the fifth patient, who did not tolerate diltiazem.
Long-term treatment with diltiazem, but not verapamil, is effective in calcinosis.
检验钙拮抗剂地尔硫䓬对钙质沉着症治疗有效的假设。
给予4例特发性或与CREST综合征相关（钙质沉着症、雷诺现象、食管运动障碍、指（趾）硬皮病、毛细血管扩张）的钙质沉着症患者，每日服用地尔硫䓬240 - 480毫克，持续1至12年。采用相同技术对患部进行系列X光片拍摄，并进行临床评估。第五例患者不耐受地尔硫䓬，服用维拉帕米，每日120毫克，持续18个月。
所有服用地尔硫䓬的患者钙化病灶均有减轻或消失，临床症状显著改善。对其中一例患者进行了长达12年的随访。此前已详细报道了该例患者治疗前5年对地尔硫䓬的反应；然而，在额外7年的治疗中，病灶进一步缩小。一名患者在因高血压服用维拉帕米期间出现了一个大的钙化病灶，在将维拉帕米换用地尔硫䓬后，出现了显著反应。维拉帕米对第五例不耐受地尔硫䓬的患者无效。
长期用地尔硫䓬治疗钙质沉着症有效，但维拉帕米无效。
