通过临床和微循环参数评估前列腺素E1在危急肢体缺血中的急性和长期影响:一项初步研究

H Stricker, U Kaiser, J Frei, F Mahler
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引用次数: 11

摘要

我们治疗了14例根据共识文件定义的严重肢体缺血(CLI)患者,这些患者排除了手术或经皮动脉重建的可能性,在3周内每天静脉注射PGE1 60微克。在1年的随访期间,通过临床、大循环和微循环参数评估效果。经PGE1治疗后,我们注意到镇痛药的使用和疼痛评分显著降低。仰卧位和坐位的前足平均tcpO2值,通过面罩吸入或不通过面罩吸入O2,在3周后以及毛细血管期均有显著改善。激光多普勒通量没有改变,但糖尿病患者的激光多普勒通量明显高于非糖尿病患者的激光多普勒通量。4例(28%)患者治疗3周后无明显改善。虽然6例患者的改善持续了4个月,但腿部最终恶化。4例(28%)患者的腿在1年后没有进一步的积极治疗。在吸氧过程中,平卧位初始tcpO2值大于40 mm Hg,坐位初始tcpO2值大于100 mm Hg的患者均无失去一条腿。尽管局部护理等其他效果可能会对结果产生有利影响,但我们注意到PGE1对大多数CLI患者的有益(尽管是短暂的)影响。吸入氧气测量TcpO2可能是积极的长期结果的有价值的预测指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute and long-term effects of prostaglandin E1 assessed by clinical and microcirculatory parameters in critical limb ischemia: a pilot study.

We treated 14 patients suffering from critical limb ischemia (CLI) as defined by the Consensus Document, and in whom possibilities of surgical or percutaneous arterial reconstruction were excluded, by PGE1 60 micrograms i.v. daily during 3 weeks. Effects were evaluated by clinical, macrocirculatory and microcirculatory parameters during a follow-up of 1 year. After treatment with PGE1, we noted a significant reduction in analgesic use and in pain score. The average tcpO2 values on the forefoot in the supine and sitting positions, with or without inhalation of O2 through a face mask, showed a significant improvement after 3 weeks, as well as capillary stage. Laser Doppler flux did not change, but was significantly higher in diabetic patients than in nondiabetics with CLI. In 4 patients (28%) no improvement could be found after 3 weeks' treatment. Although in 6 patients the improvement lasted for up to 4 months, the legs eventually deteriorated. In 4 patients (28%) the legs were preserved after 1 year without further active therapy. No patient with initial tcpO2 values above 40 mm Hg in the supine and 100 mm Hg in the sitting positions during O2 inhalation lost a leg. Although other effects like local care could have influenced the outcome favorably, we noticed a beneficial albeit transient effect of PGE1 for the majority of our patients with CLI. TcpO2 measurements with O2 inhalation might be a valuable predictor of a positive long-term result.

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