Veale D J, Muir A H, Morley K D, Belch J J
University Department of Medicine, Dundee Medical School, U.K.
Clin Rheumatol. 1995 Mar;14(2):187-90. doi: 10.1007/BF02214941.
Leg ulcers are a recognised manifestation of cutaneous vasculitis in connective tissue diseases (CTDs) including rheumatoid arthritis (RA). Iloprost a stable prostacyclin analogue has been successfully used to treat Raynaud's phenomenon and digital ulcers associated with CTD's. Our aim was to assess iloprost in the treatment of vasculitic leg ulcers in CTD. In this paper we describe eight cases of vasculitic leg ulceration in association with RA and CTD, treated with intravenous iloprost. The iloprost was administered for 6-8 hours daily and continued for 21-28 days. Immunosuppressive therapy was required in three patients with severe necrotising vasculitis (RAnv). Complete ulcer healing was achieved in four patients within 6 weeks of commencing therapy while rapid improvement occurred in the other four patients. This suggests that iloprost may be useful as an adjunct to therapy for vasculitic leg ulcers. A double-blind placebo controlled study of iloprost therapy for RA leg ulcers is under way.
腿部溃疡是包括类风湿关节炎（RA）在内的结缔组织病（CTD）中皮肤血管炎的一种公认表现。伊洛前列素是一种稳定的前列环素类似物，已成功用于治疗与CTD相关的雷诺现象和指端溃疡。我们的目的是评估伊洛前列素治疗CTD中血管炎性腿部溃疡的效果。在本文中，我们描述了8例与RA和CTD相关的血管炎性腿部溃疡病例，采用静脉注射伊洛前列素进行治疗。伊洛前列素每天给药6 - 8小时，持续21 - 28天。3例严重坏死性血管炎（RAnv）患者需要免疫抑制治疗。4例患者在开始治疗后6周内溃疡完全愈合，另外4例患者病情迅速改善。这表明伊洛前列素可能作为血管炎性腿部溃疡治疗的辅助药物有用。一项关于伊洛前列素治疗RA腿部溃疡的双盲安慰剂对照研究正在进行中。
