Evaluation of haemorheological and microcirculatory disturbances in chronic venous insufficiency: activity of Daflon 500 mg.

C Le Dévéhat, T Khodabandehlou, M Vimeux, C Kempf
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引用次数: 42

Abstract

The use of Daflon 500 mg has been shown to improve venous tone, microvascular permeability, lymphatic activity, and microcirculatory nutritive flow. This study aimed to assess the effects of Daflon 500 mg at a daily dose of 2 tab/day on microcirculatory, haemorheologic parameters, white blood cell counts and neutrophil activation in patients suffering from chronic venous insufficiency (CVI). This was a single-centre double-blind placebo-controlled study comparing two parallel groups of CVI patients who were treated for 2 months with Daflon 500 mg (n = 39) or placebo (n = 38). Evaluations were performed before treatment (D0) and at the end of treatment (D60). Blood samples were drawn from a foot vein before and at the end of a 15-min period of venous hypertension provoked by a cuff inflated to 100 mm Hg. Red blood cell (RBC) deformability was determined by the initial flow rate filtration technique using a Hanss haemorheometer. RBC aggregation was evaluated by a Myrenne aggregometer based on analysis of transmitted light through a blood sample during flow. RBC disaggregation was evaluated by Sefam erythro-aggregometer based on analysis of the backscattered light through a blood sample in a Couette flow. Microcirculatory parameters were assessed by means of laser Doppler fluxmetry and transcutaneous oxymetry measurements and consisted of continuous records of blood flux (BF) and TcPO2 before and during 15 min of venous hypertension. Results are expressed as absolute values at baseline (before stasis) and at the end of stasis, before and after 2 months of treatment. Univariate analysis showed a significant reduction of the stasis-induced RBC aggregation index (Daflon 500 mg: -0.07+/-0.20; placebo: 0.04+/-0.18; mean +/- SD; p = 0.03). Multivariate analysis identified a subset of 5 variables (RBC aggregation, RBC count, microcirculatory BF, amplitude and frequency of vasomotion) that produced a good discrimination model between the two treatments. Linear combination of these 5 variables in 48 patients with complete data showed a significant difference (p < 0.001) between the groups. These changes suggest a protective effect of Daflon 500 mg on the deleterious influence of stasis on microcirculatory (BF) and hemorheologic (RBC aggregation) parameters in CVI patients in comparison to patients receiving placebo.

评估慢性静脉功能不全的血液流变学和微循环障碍:500mg达芙蓉的活性。
使用500毫克的达芙莲已被证明可以改善静脉张力,微血管通透性,淋巴活性和微循环营养流动。本研究旨在评估Daflon 500 mg每日剂量2片/天对慢性静脉功能不全(CVI)患者微循环、血液流变学参数、白细胞计数和中性粒细胞活化的影响。这是一项单中心双盲安慰剂对照研究,比较了两组平行的CVI患者,他们分别接受达菲500毫克(n = 39)或安慰剂(n = 38)治疗2个月。分别在治疗前(D0)和治疗结束时(D60)进行评估。将袖带膨胀至100毫米汞柱,引起静脉高压,15分钟前和15分钟后分别从足静脉抽取血液样本。使用汉斯血液流变仪通过初始流速过滤技术测定红细胞(RBC)的变形能力。红细胞聚集是由Myrenne聚集计评估基于分析通过血液样品在流动过程中的透射光。采用Sefam红细胞聚集仪对库埃特血流中血液样本的背向散射光进行分析,评估红细胞分解。通过激光多普勒通量仪和经皮氧饱和度测量来评估微循环参数,包括静脉高压前和15分钟内血通量(BF)和TcPO2的连续记录。结果表示为基线(停滞前)和停滞结束时,治疗前和治疗后2个月的绝对值。单因素分析显示,Daflon 500 mg显著降低了停滞诱导的RBC聚集指数(-0.07+/-0.20;安慰剂:0.04 + / - -0.18;平均值+/- SD;P = 0.03)。多变量分析确定了5个变量(红细胞聚集、红细胞计数、微循环BF、血管舒张幅度和频率)的子集,这些变量在两种治疗之间产生了良好的区分模型。对48例资料完整的患者进行这5个变量的线性组合,组间差异有统计学意义(p < 0.001)。这些变化表明,与接受安慰剂的患者相比,500mg达芙兰对CVI患者微循环(BF)和血液流变学(RBC聚集)参数的瘀滞有害影响具有保护作用。
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