Goszcz A, Grodzinska L, Kostka-Trabka E, Bieron K, Slawinski M, Jachym R, Ochmanski W
Department of Clinical Pharmacology, Jagiellonian University Medical College, Cracow, Poland.
Methods Find Exp Clin Pharmacol. 1998 Jun;20(5):439-45. doi: 10.1358/mf.1998.20.5.485706.
Misoprostol, the oral analogue of alprostadil, was used to treat 20 patients (aged 40-60 years) with peripheral arterial disease (PAD) according to Fontaine's classification at stages IIa and IIb. All patients received 200 micrograms of misoprostol 3 times a day during a month. The therapy with misoprostol resulted in clinical improvement in all patients. Elongation of pain-free (before treatment: 129 m +/- 78 m; after treatment: 214 m +/- 109 m) and maximum walking distance (before treatment: 304 m +/- 169 m; after treatment: 471 m +/- 264 m) was observed. At the same time, a shortening of the duration of pain was noted (before treatment: 100 sec +/- 37 sec; after treatment: 71 sec +/- 23 sec). The ankle/arm pressure ratio (AAPR) and arterial blood flow increased in both limbs after 4 weeks of treatment. Activation of the fibrinolytic system was seen in the course of therapy (shortening of euglobulin clot lysis time (ECLT) and increase in t-PA activity). The platelets became less sensitive to ADP and collagen after intake of misoprostol. The results justify administration of misoprostol as a new therapeutic agent for the treatment of patients with PAD.
米索前列醇是前列地尔的口服类似物，根据Fontaine分类法，用于治疗20例年龄在40 - 60岁之间处于IIa和IIb期的外周动脉疾病（PAD）患者。所有患者在一个月内每天3次服用200微克米索前列醇。米索前列醇治疗使所有患者的临床症状得到改善。观察到无痛行走距离延长（治疗前：129米±78米；治疗后：214米±109米）和最大行走距离延长（治疗前：304米±169米；治疗后：471米±264米）。同时，疼痛持续时间缩短（治疗前：100秒±37秒；治疗后：71秒±23秒）。治疗4周后，双下肢的踝/臂压力比（AAPR）和动脉血流量增加。治疗过程中可见纤维蛋白溶解系统激活（优球蛋白凝块溶解时间（ECLT）缩短和组织型纤溶酶原激活物（t-PA）活性增加）。服用米索前列醇后，血小板对二磷酸腺苷（ADP）和胶原的敏感性降低。这些结果证明米索前列醇可作为治疗PAD患者的一种新的治疗药物。
