糖尿病性末梢神経障害に対するLipo-Prosta-glandin E₁ (Lipo-PGE₁) の有効性

抄録

It is thought that the pathogenesis of diabetic peripheral neuropathy consists of various factors including vascular and metabolic disorders. Therefore, prostaglandin E₁ (PGE₁) has been used clinically both for patients with peripheral vasculr disease and those with diabetic peripheral neuropathy due to the vasodilative and anti-platelet effects of PGE₁. Recently, a novel prostaglandin E₁ infusion therapy using a lipid microsphere was developed in order to increase some of the advantages of PGE₁ therapy.
In this study, we investigated the clinical effects of lipo-prostaglandin E₁ (Lipo-PGE₁) on diabetic peripheral neuropathy. Fifty-two diabetics with neuropathy were given Lipo-PGE₁ once daily by intravenous drip infusion at a dosage of 5μg of PGE₁. Thc treatment lasted for a period of at least 2 weeks as a rule.
An improvement rating of 70% in the subjective symptoms was obtained in diabetic peripheral neuropathy including spontaneous pain (81.3%), hypesthesia and numbness (72.0%). Though there was a significant improvement (p<0.05) in motor nerve conduction velocity of the ulnar nerve, no appreciable effect on other nerve function tests (the Achilles tendon reflex, vibratory sense, motorsensory nerve conduction velocity, etc.) was observed.
The global improvement rating, which was assessed on the basis of improvement in subjective symptoms and nerve function tests, was 82.7%, or 43 out of 52 cases. Side efThets were seen in 4 patients: these included slight phlebitis, dizziness, faintness and diarrhea in one patient each. An assessment of usefulness demonstrated that Lipo-PGE₁ was useful in 13 eases or 82.7%.
The above results suggest that Lipo-PGE₁ is a useful drug for the improvement of subjective symptoms and nerve function tests in diabetic neuropathy.