何川?丁洋?顾俊菲?万圣云

    【摘要】 目的 探討原发性大隐静脉曲张传统开放性手术与激光治疗联合泡沫硬化术对机体免疫系统的影响。方法 按照手术方式将104例择期行大隐静脉曲张手术的患者分为激光治疗联合泡沫硬术组(MIS组，53例)和传统开放性手术组(OS组，51例)。分别于术前和术后24 h采集2组静脉血测定超氧化物岐化酶(SOD)、IL-1β、IL-6、IL-8、IL-10、TNF-α、干扰素-γ(IFN-γ)水平。采用流式细胞术检测T淋巴细胞亚群及自然杀伤细胞(NK)的比例变化。采用单细胞测序(scRNA-seq)技术检测外周血免疫细胞差异基因表达。结果 MIS组术后IL-1β、IL-8水平较术前高(P均< 0.05)，术前与术后的SOD、IL-6、IL-10、TNF-α、IFN-γ水平比较差异无统计学意义(P均> 0.05)；OS组上述指标术前与术后比较差异均有统计学意义(P均< 0.05)。MIS组术前与术后T淋巴细胞亚群及NK比例比较差异均无统计学意义(P均 > 0.05)；OS组术后24 h CD8+ T细胞比例升高，NK比例降低(P均< 0.05)。术后24 h

    外周血免疫细胞表达差异基因功能富集分析提示OS组术后缺氧应答、IFN应答及NF-κB等炎症通路较MIS组上调。结论 大隐静脉曲张激光治疗联合泡沫硬化术对机体系统免疫炎症及缺氧反应影响较小，能够更好地维持机体的免疫平衡，较大程度保留机体原有免疫系统抵御微生物入侵的能力。

    【关键词】 原发性大隐静脉曲张；激光治疗；泡沫硬化术；炎症；免疫；缺氧

    Comparison of the effects between traditional open surgery and laser treatment combined with foam sclerotherapy on immune system in patients with primary great saphenous varicose veins He Chuan△， Ding Yang， Gu Junfei， Wan Shengyun. △Department of Intervention， the Second Affiliated Hospital of Wannan Medical College， Wuhu 241000， China

    Corresponding author， Wan Shengyun， E-mail： wshy63@sina.com

    【Abstract】 Objective To compare the effects of traditional open surgery? and laser therapy combined with foam sclerotherapy on immune system in patients with primary saphenous varicose veins. Methods A total of 104 patients who underwent elective varicose vein surgery were divided into the laser therapy combined with foam sclerotherapy group (MIS group ......