Pibiri L, Petruzzo P, Angius D, Ruiu G, Polo F, Rescigno A, Brotzu G
Dipartimento Scienze Chirurgiche, Università degli Studi, Cagliari.
Minerva Cardioangiol. 1997 Dec;45(12):621-5.
Iloprost, a prostaglandin I2, is chemically stable and it has been successfully used by intravenous infusion in severe limb ischemia. Usually Iloprost is diluted in 0.9% sodium chloride solution and infused intravenously for six hours each day for 28 days in hospital.
In the present study after the first three days of infusion with a traditional pump in hospital, a home pump has been utilised for the infusion of Iloprost at home. This device allows the continue infusion of Iloprost at a flow rate of 2 ml/h for six days, then the pump is filled with a new solution. The home pump consists of a protective shell in polycarbonate (10 x 12 cm), 270 ml of volume, inside there is a balloon reservoir (3 membranes) which is filled with Iloprost. The structure of Iloprost does not change into the home pump as evidenced by HPLC studies and its continue infusion allows plasmatic high levels of its active isomers during the 28 days of therapy. In 30 patients, 25 men and 5 women (mean age 61 years) with Fontaine stage IIB (6), III (5) and IV (19) POAD Iloprost has been infused with the home pump. The follow-up period was 1 to 16 months.
The results have shown 4 major amputations and 1 death, in 9 patients complete pain relief and ulcer healing, and in 6 patients only improvement in relief of rest pain and ulcers.
All the patients appreciated this system of infusion because they had a normal life; in addition it is less expensive because the patients stay in hospital only 3 days.
伊洛前列素是一种前列腺素I2，化学性质稳定，已成功用于严重肢体缺血的静脉输注治疗。通常，伊洛前列素用0.9%氯化钠溶液稀释后，在医院进行静脉输注，每天6小时，共28天。
在本研究中，患者在医院使用传统泵输注三天后，改为在家使用家用泵输注伊洛前列素。该装置可使伊洛前列素以2毫升/小时的流速持续输注6天，然后更换新的溶液。家用泵由聚碳酸酯制成的保护壳（10×12厘米）组成，容积为270毫升，内部有一个气囊贮液器（3个隔膜），里面装有伊洛前列素。高效液相色谱研究表明，伊洛前列素在家庭泵中的结构未发生变化，其持续输注可使治疗的28天内血浆中其活性异构体保持高水平。对30例患者（25例男性和5例女性，平均年龄61岁）进行了研究，这些患者患有Fontaine IIB期（6例）、III期（5例）和IV期（19例）的外周动脉疾病（POAD），均使用家用泵输注伊洛前列素。随访期为1至16个月。
结果显示有4例患者进行了大截肢手术，1例死亡，9例患者疼痛完全缓解且溃疡愈合，6例患者仅静息痛和溃疡有所改善。
所有患者都对这种输注系统表示满意，因为他们可以正常生活；此外，该方法费用较低，因为患者只需住院3天。
