NIFEDIPINE IN PRIMARY RAYNAUDS-PHENOMENON AND IN SCLERODERMA - ORAL VERSUS SUBLINGUAL HEMODYNAMIC-EFFECTS
NIFEDIPINE IN PRIMARY RAYNAUDS-PHENOMENON AND IN SCLERODERMA - ORAL VERSUS SUBLINGUAL HEMODYNAMIC-EFFECTS
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DOI：
10.1002/j.1552-4604.1987.tb05587.x
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发表时间：
1987-11-01
影响因子：
2.9
通讯作者：
VANTLAAR, A
中科院分区：
文献类型：
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作者：
WOLLERSHEIM, H;THIEN, T;VANTLAAR, A
在16例雷诺现象患者中，进行了一项安慰剂对照单剂量研究，研究舌下给药10 mg硝苯地平对血流动力学的影响，随后进行了一项为期8周的开放性研究，研究慢性口服硝苯地平10 mg qid的疗效。舌下含服硝苯地平后，在标准手指冷却试验中，手指皮肤（P = 0.013）和前臂肌肉血流量（P = 0.04）有明显的客观改善，在慢性口服研究中，除了激光多普勒估计的分流流量（P = 0.07）外，客观疗效参数的改善消失。急性血流动力学效应不能预测个体患者的长期结果。系统性硬化症患者的反应与原发性雷诺现象患者一样。这项研究表明，口服硝苯地平不会给雷诺现象患者带来长期的客观益处。急性给药时血管舒张明显增加，提示舌下含服硝苯地平可能更有效。
In 16 patients with Raynaud''s phenomenon a placebo-controlled single-dose study was performed on the hemodynamic effects of 10 mg nifedipine, sublingually administered, followed by an open eight-week study on the therapeutic efficacy of chronic oral nifedipine, 10 mg qid. After the acute sublingual nifedipine administration, a pronounced objective improvement of finger skin (P = .013) and forearm muscle blood flow (P = .04) during a standard finger-cooling test was found. During the chronic oral study the improvement in objective efficacy parameters disappeared, except for laser Doppler estimated shunt flow (P = .07). The acute hemodynamic effects did not predict the long-term results in individual patients. Patients with systemic sclerosis reacted as well as patients with primary Raynaud''s phenomenon. This study shows that orally administered nifedipine does not convey long-term objective benefit to patients with Raynaud''s phenomenon. The apparent increase in vasodilation during acute administration suggests that sublingual nifedipine prophylactically or during a vasospastic attack may be more useful.