妊娠期肝内胆汁淤积症（intrahepatie cholestasis of pregnancy，ICP）是妊娠特有的并发症，其严重危害是突然胎死宫内，具体机制尚未明了，可能是急性缺氧的结果，与子宫-胎盘-胎儿单位功能及其血流调节有关。胎盘小叶血管无神经分布...妊娠期肝内胆汁淤积症（intrahepatie cholestasis of pregnancy，ICP）是妊娠特有的并发症，其严重危害是突然胎死宫内，具体机制尚未明了，可能是急性缺氧的结果，与子宫-胎盘-胎儿单位功能及其血流调节有关。胎盘小叶血管无神经分布，子宫-胎盘-胎儿单位血管床血流调控依赖于局部产生和循环中的血管舒张因子。促肾上腺皮质激素释放激素（corticotropin-releasing hormone，CRH）是近年研究较多的血管活性物质，主要由胎盘组织分泌，是妊娠期特殊标志物，对子宫-胎盘-胎儿单位血管具有强效的浓度依赖性舒张作用。展开更多
Background: Delayed pressure urticaria (DPU) is characterized by the appearance of typical painful skin lesions (weals) after pressure stimulus. Oral corticosteroids are effective treatments but long-term therapy is p...Background: Delayed pressure urticaria (DPU) is characterized by the appearance of typical painful skin lesions (weals) after pressure stimulus. Oral corticosteroids are effective treatments but long-term therapy is problematic. A new topical formulation of clobetasol propionate 0.05%in thermophobic foam (CF) (Olux) has recently become available. The foam is easy to apply, with low skin residues. Objectives: To evaluate in a double-blind placebo-controlled trial the efficacy, tolerability and safety of CF in the topical treatment of DPU. Methods: Twenty-six subjects with a positive history of DPU (13 men, mean age 44 years) were enrolled in a 4-week trial. CF or the corresponding placebo were applied twice daily. Drug application was performed in the most affected areas and in a target area where a standardized pressure challenge test was performed at baseline and at week 4. Efficacy was evaluated by scoring skin lesions regarding erythema, oedema and itching (0, no sign; 4, severe signs) and by calculating the area of the pressure challenge-induced lesion. Safety was evaluated by measuring plasma levels of adrenocorticotropic hormone (ACTH) and cortisol. Results: CF significantly (P = 0.0001) reduced lesion area by 84%in comparison with baseline values and by 97%in comparison with the placebo group values. Lesion area in the CF group was reduced from 144 cm2 to 21 cm2 at the end of the study. No significant differences in lesion area and clinical lesion scores were observed in the placebo group (lesion area 201 cm2 at baseline; 216 cm2 after 4 weeks). A significant clinical improvement was observed in all treated skin areas in the CF group. Mean ±SD erythema score was reduced by CF from 1.8 ±0.6 at baseline to 0.6 ±0.5 at the end of the treatment (P = 0.001). Similar modifications were observed also for oedema (from 1.6 ±0.6 to 0.2 ±0.5) and itching score. Nonsignificant modifications of plasma levels of ACTH, cortisol and glucose were observed in both study groups, in comparison with baseline values. No adverse events were recorded during the trial in either treatment group. Conclusions: CF is effective, safe, convenient and well tolerated in the short-term treatment of DPU.展开更多
文摘妊娠期肝内胆汁淤积症（intrahepatie cholestasis of pregnancy，ICP）是妊娠特有的并发症，其严重危害是突然胎死宫内，具体机制尚未明了，可能是急性缺氧的结果，与子宫-胎盘-胎儿单位功能及其血流调节有关。胎盘小叶血管无神经分布，子宫-胎盘-胎儿单位血管床血流调控依赖于局部产生和循环中的血管舒张因子。促肾上腺皮质激素释放激素（corticotropin-releasing hormone，CRH）是近年研究较多的血管活性物质，主要由胎盘组织分泌，是妊娠期特殊标志物，对子宫-胎盘-胎儿单位血管具有强效的浓度依赖性舒张作用。
文摘Background: Delayed pressure urticaria (DPU) is characterized by the appearance of typical painful skin lesions (weals) after pressure stimulus. Oral corticosteroids are effective treatments but long-term therapy is problematic. A new topical formulation of clobetasol propionate 0.05%in thermophobic foam (CF) (Olux) has recently become available. The foam is easy to apply, with low skin residues. Objectives: To evaluate in a double-blind placebo-controlled trial the efficacy, tolerability and safety of CF in the topical treatment of DPU. Methods: Twenty-six subjects with a positive history of DPU (13 men, mean age 44 years) were enrolled in a 4-week trial. CF or the corresponding placebo were applied twice daily. Drug application was performed in the most affected areas and in a target area where a standardized pressure challenge test was performed at baseline and at week 4. Efficacy was evaluated by scoring skin lesions regarding erythema, oedema and itching (0, no sign; 4, severe signs) and by calculating the area of the pressure challenge-induced lesion. Safety was evaluated by measuring plasma levels of adrenocorticotropic hormone (ACTH) and cortisol. Results: CF significantly (P = 0.0001) reduced lesion area by 84%in comparison with baseline values and by 97%in comparison with the placebo group values. Lesion area in the CF group was reduced from 144 cm2 to 21 cm2 at the end of the study. No significant differences in lesion area and clinical lesion scores were observed in the placebo group (lesion area 201 cm2 at baseline; 216 cm2 after 4 weeks). A significant clinical improvement was observed in all treated skin areas in the CF group. Mean ±SD erythema score was reduced by CF from 1.8 ±0.6 at baseline to 0.6 ±0.5 at the end of the treatment (P = 0.001). Similar modifications were observed also for oedema (from 1.6 ±0.6 to 0.2 ±0.5) and itching score. Nonsignificant modifications of plasma levels of ACTH, cortisol and glucose were observed in both study groups, in comparison with baseline values. No adverse events were recorded during the trial in either treatment group. Conclusions: CF is effective, safe, convenient and well tolerated in the short-term treatment of DPU.
