［総説］末梢動脈疾患に対する薬物＋運動療法
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Trans Atlanticinter-Society Consensus (TASC)) II strongly recommends walking exercise and anti-platelet agents for patients with peripheral arterial disease(PAD).We have reported that a program combining heparin administration with exerciseis a useful therapeutic strategy for stimulation of collateral development in ischemic legs in patients with non-Option PAD via transient increase in hepatocyte growth factor. To examine a hypothesis that additional combination of lipo-Prestaglandin(PG）E1,a Potent vasodilator and inhibitor of platelet aggregation, accelerates the effectiveness of heparin + exercise program in patients with non-option PAD, 20 symptomatic no option PAD (Fontaine II or III）patients were randomly assigned in adouble blind fashion to two groups; a group of lipo-PGEl(+) (supervised walking for 60min/day after intravenous administration of 3,000 units heparin and 10 $ \mu $g lipo-PGE1 for 14days, n=10) and a group of lipo-PGEl(-) (same supervised walking program after administration of heparin and saline,n=10). After 14-day-initial treatment,the patients of both groups did ambulatory exercise under supervision for 60 min once a day, 3 days/week during a period of following 22 weeks. Additional administration of lipo-PGE1 on heparin + exercise program brings the therapeutic gain appearance forward．This beneficial short-term effect may encourage patients with non-Option PAD to maintain exercise trainlng.
- 琉球医学会,Ryukyu Medical Associationの論文
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