Messa G, La Placa G, Puccetti L, Di Perri T
Istituto di Clinica Medica e Terapia Medica, Università degli Studi, Siena.
Minerva Cardioangiol. 1997 Apr;45(4):147-53.
One of the most interesting glycosaminoglycans (GAGs) is heparansulphate, known as the physiological activator of antithrombin III and involved in the maintenance of the antithrombotic potential of uninjured endothelium. The aim of our study was to evaluate the tolerability and effectiveness of heparansulphate with respect to sulodexide, another GAG suitable for the treatment of venous diseases. The study was performed in a open-label, controlled, with parallel and randomized groups, design. Thirty patients (aged 32-72 years) suffering from superficial thrombophlebitis were treated for two weeks with heparansulphate 100 mg t.i.d. or sulodexide 250 LSU b.i.d., both given orally. Some coagulative and fibrinolytic parameters (PT; aPTT; fibrinogen; euglobulin lysis time; t-PA; PAI-1; ATIII; alpha 2-antiplasmin; D-Dimer and platelets count) were assayed at the beginning and at the end of the study. Moreover signs and symptoms of disease (skin trophism; local pain; itch and oedema) were assessed. Heparansulphate and sulodexide were able to reduce signs and symptoms with similar degree and to significantly modify t-PA, alpha 2-antiplasmin and ATIII levels without any difference between treatments. Our issues show that heparansulphate can be useful in superficial thrombophlebitis management.
最有趣的糖胺聚糖（GAGs）之一是硫酸乙酰肝素，它被认为是抗凝血酶III的生理激活剂，并参与维持未受损内皮的抗血栓形成潜力。我们研究的目的是评估硫酸乙酰肝素相对于舒洛地昔（另一种适用于治疗静脉疾病的GAG）的耐受性和有效性。该研究采用开放标签、对照、平行随机分组设计。30例（年龄32 - 72岁）患有浅表性血栓性静脉炎的患者接受为期两周的治疗，其中100 mg硫酸乙酰肝素每日三次口服，或250 LSU舒洛地昔每日两次口服。在研究开始和结束时检测了一些凝血和纤溶参数（PT；活化部分凝血活酶时间；纤维蛋白原；优球蛋白溶解时间；组织型纤溶酶原激活物；纤溶酶原激活物抑制剂-1；抗凝血酶III；α2-抗纤溶酶；D-二聚体和血小板计数）。此外，还评估了疾病的体征和症状（皮肤营养状况；局部疼痛；瘙痒和水肿）。硫酸乙酰肝素和舒洛地昔能够以相似程度减轻体征和症状，并显著改变组织型纤溶酶原激活物、α2-抗纤溶酶和抗凝血酶III水平，两种治疗之间无任何差异。我们的研究结果表明硫酸乙酰肝素在浅表性血栓性静脉炎的治疗中可能有用。
