Objectives To compare changes of the Birmingham vasculitis activity score (BVAS) and some laboratory parameters in thrombangiitis obliterans patients (pts) treated with antiplatelet agents and vasodilators in usual doses (first group) and with standard three-days scheme glucocorticoid and cyclophosphamide pulse-therapy (second group).
Methods The first group included 12 male (mean age 37.9 ± 6.9 years) and the other one – 16 male (mean age 41.3 ± 7.5 years). Duration of disease and clinical symptoms before the treatment were comparable in both groups, excepting the frequency of joints pain (n1 = 41.7% v.s. n2 = 6.3%; p < 0.05) and migratory superficial phlebitis (n1 = 66.7% v.s. n2 = 18.8%; p < 0.05), which were observed significantly more often in pts of the first group. Inspection of the pts was carried out before treatment and in a month. An estimation of clinical activity has carried out on BVAS. Serum levels of C-reactive protein (CRP) by ELISA and ESR at the same time were determinated as well.
Results Before the start of treatment there were no significant differences in values of BVAS (8.2 ± 3.5 -first group; 8.4 ± 3.2 – second group), ESR and CRP between both groups. In a month BVAS was significantly lower in pts of the second group, then in the first one (6.8 ± 3.3 – first group v.s. 3.9 ± 1.7 – second group; p < 0.05). The mean values of CRP were not significantly changes during follow-up in both groups, but high serum levels of CRP were founded significantly more often in pts of the first group then in the second after the treatment (n1 = 58.3%; n2 = 56.3% – before; n1 = 66.7%; n2 = 18.8%; p < 0.05 – after the treatment, respectively). The similar features were observed for the frequency of amputations (n1 = 58.33% v.s. n2 = 12.5%; p < 0.05).
Conclusion So, the pulse-therapy has more considerable anti-inflammatory effect comparing to antiplatelet agents and vasodilators, therefore it is necessary to include it in the scheme of therapy pts with thrombangiitis obliterans.
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