Schellong S M, Burchert W, Böger R M, Creutzig A, Hundeshagen H, Alexander K
Department of Angiology, Hannover Medical School, Germany.
Scand J Clin Lab Invest. 1998 Apr;58(2):109-17. doi: 10.1080/00365519850186689.
Increase of blood flow in the ischaemic leg is believed to represent the main action of prostaglandin E1 (PGE1) in the therapy of peripheral vascular disease (PVD). There is no reliable data in man concerning the amount of increase in muscular blood flow (MBF) of the calf, and the difference between intra-arterial and intravenous application.
We conducted a positron emission tomography (PET) study of MBF with 15O-water as flow tracer. Fifteen patients with PVD and three healthy volunteers were given 5 micrograms PGE1 intra-arterially over 50 min; PET scans were taken at 0, 25 and 50 min. Additionally, eight of the patients were investigated during an intravenous infusion of 40 micrograms PGE1 over 120 min; PET scans were taken at 0, 30, 60 and 120 min.
Increase of muscular blood flow by intra-arterial PGE1 averaged 80%. A steal phenomenon was not observed. The amount of flow enhancement depended on whether or not the femoral artery was patent. During intravenous PGE1, muscular blood flow remained unchanged.
In man, the pharmacodynamic profile of intra-arterial PGE1 differs clearly from intravenous PGE1. The flow-enhancing property is lost during metabolization in the lung. Since no difference exists between the therapeutic efficacy of intraarterial and intravenous PGE1, the impact on muscular blood flow is not as important as suggested previously.
缺血腿部血流量的增加被认为是前列腺素E1（PGE1）治疗周围血管疾病（PVD）的主要作用。关于小腿肌肉血流量（MBF）增加的量以及动脉内给药和静脉内给药之间的差异，在人体中尚无可靠数据。
我们使用15O-水作为血流示踪剂进行了一项正电子发射断层扫描（PET）研究，以测量MBF。15例PVD患者和3名健康志愿者在50分钟内动脉内给予5微克PGE1；在0、25和50分钟时进行PET扫描。此外，对其中8例患者在120分钟内静脉输注40微克PGE1期间进行了研究；在0、30、60和120分钟时进行PET扫描。
动脉内给予PGE1后肌肉血流量平均增加80%。未观察到窃血现象。血流量增加的量取决于股动脉是否通畅。静脉给予PGE1期间，肌肉血流量保持不变。
在人体中，动脉内给予PGE1的药效学特征与静脉内给予PGE1明显不同。在肺内代谢过程中，血流增强特性丧失。由于动脉内和静脉内给予PGE1的治疗效果没有差异，因此对肌肉血流量的影响并不像先前认为的那么重要。
