前列环素在风湿疾病的应用.ppt

血管性假性血友病因子(vWF),内皮功能损害的重要标志物之一 血中Von-Willebrand因子(血管性假性血友病因子，VwF)水平增高，说明硬皮病血管炎患者的内皮细胞被激活。VwF因子有活化血小板和促进血小板粘附的作用，促发血管内凝血，还能使成纤维细胞趋化和分裂的作用，使成纤维细胞分泌大量胶原，导致内膜纤维化。由损伤的血管壁向外渗透时，可导致外膜和血管周围组织纤维化。 而凯那能显著降低血管假性血友病因子减轻血管内皮损害。 * 有一个125例雷诺现象患者入选的试验，该试验把患者分为了贝前组和安慰剂组，来观察贝前的治疗效果。 研究的是雷诺现象的发生频率、严重程度，总体致残率等 J Rheumatol. 1996 Nov;23(11):1917-20. Controlled multicenter double blind trial of an oral analog of prostacyclin in the treatment of primary Raynauds phenomenon. French Microcirculation Society Multicentre Group for the Study of Vascular Acrosyndromes. Vayssairat M. Author information H?pital Tenon, Paris, France. Abstract OBJECTIVE: To compare the efficacy and tolerance of beraprost sodium, an oral prostanoid prostaglandin I2 analog, with a placebo in patients with primary Raynauds phenomenon (RP). METHODS: 125 patients with disabling primary RP participated in a multicenter, randomized, double blind trial in 2 parallel groups, lasting 8 weeks, and conducted during the winter months only; a meteorological survey was also conducted for each patient. Main outcome measures were frequency and severity of attacks of RP, overall disability, and digital cold challenge tests. RESULTS: The number of attacks decreased significantly in both groups (confidence intervals of improvement: 35-53% in beraprost group and 25-49% in placebo group), but did not differ significantly in the 2 groups. Similar results were found for the severity of RP attacks and overall disability. No severe side effects occurred, but headache was more frequent in the beraprost group (p = 0.001). Cold tests remained equally abnormal in both groups throughout the study. CONCLUSION: Although we observed 37% improvement in the number of attacks of RP in the beraprost group, prostanoid treatment proved no more beneficial than placebo. * 文章显示贝前降低雷诺现象发作次数达37% Controlled multicenter double?blind trial of an oral analog of prostacyclin in the treatment of primary?Raynaudsphenomenon. French Microcirculation So