Cina G, Vernich M, Campisi C, Cascone C, Ofria F, Leopardi N, Maniscalco G, Moricca N, Ceccarelli V, Paolicelli D, Carbone D
Istituto di Clinica Chirurgica Generale, Università Cattolica del Sacro Cuore, Roma.
Minerva Cardioangiol. 1996 Apr;44(4):179-85.
In the treatment of peripheral obliterating arteriopathy (POA) physical training provides clear results in terms of increased walking autonomy; it is still not fully clear whether the positive effects of physical training can be further improved by concomitant back-up drug therapy. For this purpose 374 patients of both sexes, with a mean age of 64 years, suffering from chronic peripheral obliterating arteriopathy of the lower limbs were enrolled in a controlled open clinical trial, instructed to follow a programme of physical training and randomly allocated to low dose treatment with heparin calcium (12,500 IU/day) for 6 months. An improvement in the claudicometric parameters (free gait interval, absolute gait interval and recovery time) measured at constant speed and in the resting Winsor ankle/arm index of the most severely damaged limb were observed in both groups. These improvements were significantly greater in the group receiving pharmacological treatment (p < 0.01) and efficacy increased in line with basal deambulatory impairment. The results obtained and the good tolerance of the drug underline the clinical efficacy of heparin calcium at low doses in association with a physical training programme in patients suffering from Fontaine's stage II peripheral obliterating arteriopathy.
在治疗外周闭塞性动脉病（POA）方面，体育锻炼在提高步行自主性方面取得了明显成效；体育锻炼的积极效果是否能通过联合辅助药物治疗进一步改善，目前仍不完全清楚。为此，374例平均年龄64岁、患有下肢慢性外周闭塞性动脉病的男女患者参与了一项对照开放性临床试验，他们被要求遵循体育锻炼计划，并被随机分配接受低剂量肝素钙治疗（12,500国际单位/天），为期6个月。两组均观察到在恒定速度下测量的跛行参数（自由步态间隔、绝对步态间隔和恢复时间）以及最严重受损肢体静息状态下的温索尔踝/臂指数有所改善。接受药物治疗的组中这些改善更为显著（p < 0.01），且疗效随基础步行障碍程度的增加而提高。所获得的结果以及药物的良好耐受性突显了低剂量肝素钙与体育锻炼计划联合应用于患有Fontaine II期外周闭塞性动脉病患者的临床疗效。
