In a double blind, randomized multicenter study naftidrofuryl, a vasoactive substance, was compared with placebo in the treatment of 104 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either naftidrofuryl (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the difference in the improvement of the pain-free walking distance was significant (p less than 0.02) in favour of naftidrofuryl. There also was a difference in the improvement of the total walking distance in favour of naftidrofuryl which was not significant. The results indicate that naftidrofuryl has a beneficial effect on the symptoms and lengthens the painfree walking distance in patients with arterial occlusive disease.
Parameters characterizing the hemoglobin oxygen affinity were determined in blood of 12 male patients suffering from arterial occlusive disease (AOD) of the legs and compared with data obtained earlier from healthy human subjects (controls). Due to a COHb content of 4.8% +/- 2.2% in the cigarette-smoking AOD patients, the standard oxygen dissociation curve (ODC) was left-shifted, the half-saturation pressure (P50) amounted to 24.8 +/- 1.7 mmHg (3.30 +/- 0.23 kPa), although the 2,3-diphosphoglycerate concentration was increased to 15.3 +/- 1.7 mumol/g Hb. Correcting the effects of elevated COHb shifts the P50 to 26.3 mmHg (3.5 kPa) and increases the steepness of the ODC (Hill's "n") from 2.79 +/- 0.27 to about 2.99, which is significantly different from controls. The Bohr coefficients after acidification of blood with lactic acid (BCLac) show high values at low oxygen saturations of hemoglobin (-0.50 +/- 0.04 in AOD patients, -0.32 +/- 0.04 in controls; P less than 0.05 at 10% SO2). The cause of the alterations in hemoglobin oxygen affinity may be a reduced mean erythrocyte age, but also the influence of unknown factors generated, e.g., from anaerobic muscle metabolism in AOD.
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