OBJECTIVE
To evaluate the effect of the drug Slavinorm on the immediate results of treatment and to develop a treatment algorithm for patients with diseases of the arteries of the lower extremities of atherosclerotic etiology.
MATERIAL AND METHODS
The study included 78 patients with obliterating atherosclerosis of the arteries of the lower extremities, stage IIb of the disease according to A.V. Pokrovsky-Fontein, which were divided into two comparable groups. Patients were monitored from the moment of diagnosis of obliterating atherosclerosis and the start of therapy, and for 3 months. All patients were divided into two groups. In group 1 (38 patients), the treatment method was basic therapy (acetylsalicylic acid, atorvastatin, antihypertensive drugs)+Slavinorm intramuscularly, at a dose of 5 mg, 2 times per week, with a treatment period of 5 weeks (10 doses). In group 2 (40 patients), the method of correcting blood flow was basic therapy (acetylsalicylic acid, atorvastatin, antihypertensive drugs)+pentoksyphylline, according to the National recommendations for the management of patients with peripheral arterial diseases.
RESULTS
In patients of the first group, 3 months after the first injection of the drug, there was an increase in pain-free walking distance (PFWD) by 35—40 m in 22 patients (57.89%), in 12 patients (31.58%) there was an increase in PFWD by 15―10 m and in 4 patients (10.53%) without dynamics. According to ultrasound data, in both groups there was a significant increase in ABI from 0.7 to 0.8 (p<0.001) 2 month from the start of treatment. After 3 months, in the group using the drug Slavinorm, the ABI indicator stays at the same level as after 2 months (p>0.05). In the control group, after 3 months there was a decrease in Ankle-brachial index (ABI) from 0.8 to 0.7 (p=0.006). At the same time, 25% of patients in the second group have a level of increase in laser Doppler flowmetry (LDF) above 60%, while in the first group this level of increase is minimal, and 75% of patients have an increase in LDF above 120%. The median level in the first group is also 2 times higher than the value of the second group.
CONCLUSION
The inclusion of Slavinorm in conservative therapy helps to improve microcirculation, increase the volume of the microvasculature by 128% and increase the distance of pain-free walking.