血管重建术治疗血栓闭塞性脉管炎患者的疗效观察(1)
【摘要】目的探讨血管重建术治疗血栓闭塞性脉管炎(TAO)患者临床治疗效果。
方法选取有介入治疗指征的下肢TAO患者18例为治疗组，用血管重建术加西药治疗；选取同期单纯用西药治疗的TAO患者31例为对照组，两组疗程均为3 个月。比较两组患者治疗效果，观察治疗前后两组患者血清白细胞介素6(IL6)、白细胞介素8(IL8)和肿瘤坏死因子α(TNFα)的变化情况。
结果两组治疗效果比较差异无统计学意义(P>0.05)。治疗前两组血清IL6、IL8和TNFα水平比较差异无统计学意义(P>0.05)。治疗后，治疗组血清IL6、IL8和TNFα显著降低(P<0.01)；对照组血清IL8和TNFα水平显著降低(P<0.01)，IL6水平变化不大(P>0.05)；治疗组IL6、IL8和TNFα均显著低于对照组(P<0.01)。提示治疗组对患者免疫损伤的改善作用优于对照组。
结论血管重建术治疗TAO对改善患者的临床症状和炎症细胞因子功能紊乱的效果优于单纯西药治疗，为提高临床疗效奠定基础。
【关键词】血管重建术；血栓闭塞性脉管炎；炎症细胞因子
中图分类号：R654.4文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.002
【Abstract】ObjectiveTo investigate the clinical effect of revascularization for patients with thromboangiitis obliterans(TAO).
Methods18 cases of lower extremity TAO with indications of interventional therapy and treated with revascularization+Western medicine were selected as treatment group，and 31 cases who treated with Western medicine only during the same period were selected as control group.Both groups were treated for 3 months.Then，the therapeutic effects of the two groups were compared，and the changes of serum interleukin6(IL6)，interleukin8 (IL8) and tumor necrosis factorα(TNFα) were observed before and after treatment.
ResultsDifference of the therapeutic effects between the two groups was not statistically significant(P>0.05).Before treatment，difference of serum IL6，IL8 and TNFα levels was not statistically significant(P>0.05).After treatment，however，serum IL6，IL8 and TNFα levels of the treatment group significantly decreased(P<0.01)，and serum IL8 and TNFα levels of the control group significantly decreased(P<0.01)，while change of serum IL6 was not obvious(P>0.05).Serum IL6，IL8 and TNFα levels of the treatment group were significantly lower than those of the control group(P<0.01)，which suggested that the improvement of immune injury in the treatment group was better.
ConclusionRevascularization therapy for TAO has better effect in improving clinical symptoms and inflammatory cytokine dysfunction than pure treatment with Western medicine，it lays a foundation for improving the clinical curative effect.
【Key words】revascularization；TAO；inflammatory cytokines；bloodstasis obstruction
血栓闭塞性脉管炎(Thromboangiitis obliterans，TAO)是由于血管壁全层炎症引起的中小动脉闭塞，累及邻近靜脉和神经的进行性、节段性、非感染性血管损害疾病，其病理变化主要是病变的血管出现继发腔内炎症细胞浸润性血栓、管腔闭塞和机化[1]。临床上以下肢多见，早期表现为间歇性跛行，晚期表现为严重静息痛、肢端溃疡和变黑坏死，最终需高位截肢[2]。TAO病因尚不完全明确，疗效欠佳[3]。为探讨血管重建对TAO的疗效，我们选取有介入治疗指征的下肢TAO患者18例用血管腔内介入加西药治疗，并与31例单纯用西药治疗的TAO患者进行对照，现总结报告如下。, http://www.100md.com(曾德创 邹才华 李近都 陈宏明 罗世官 李天资 唐习强 梁烨)
方法选取有介入治疗指征的下肢TAO患者18例为治疗组，用血管重建术加西药治疗；选取同期单纯用西药治疗的TAO患者31例为对照组，两组疗程均为3 个月。比较两组患者治疗效果，观察治疗前后两组患者血清白细胞介素6(IL6)、白细胞介素8(IL8)和肿瘤坏死因子α(TNFα)的变化情况。
结果两组治疗效果比较差异无统计学意义(P>0.05)。治疗前两组血清IL6、IL8和TNFα水平比较差异无统计学意义(P>0.05)。治疗后，治疗组血清IL6、IL8和TNFα显著降低(P<0.01)；对照组血清IL8和TNFα水平显著降低(P<0.01)，IL6水平变化不大(P>0.05)；治疗组IL6、IL8和TNFα均显著低于对照组(P<0.01)。提示治疗组对患者免疫损伤的改善作用优于对照组。
结论血管重建术治疗TAO对改善患者的临床症状和炎症细胞因子功能紊乱的效果优于单纯西药治疗，为提高临床疗效奠定基础。
【关键词】血管重建术；血栓闭塞性脉管炎；炎症细胞因子
中图分类号：R654.4文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.002
【Abstract】ObjectiveTo investigate the clinical effect of revascularization for patients with thromboangiitis obliterans(TAO).
Methods18 cases of lower extremity TAO with indications of interventional therapy and treated with revascularization+Western medicine were selected as treatment group，and 31 cases who treated with Western medicine only during the same period were selected as control group.Both groups were treated for 3 months.Then，the therapeutic effects of the two groups were compared，and the changes of serum interleukin6(IL6)，interleukin8 (IL8) and tumor necrosis factorα(TNFα) were observed before and after treatment.
ResultsDifference of the therapeutic effects between the two groups was not statistically significant(P>0.05).Before treatment，difference of serum IL6，IL8 and TNFα levels was not statistically significant(P>0.05).After treatment，however，serum IL6，IL8 and TNFα levels of the treatment group significantly decreased(P<0.01)，and serum IL8 and TNFα levels of the control group significantly decreased(P<0.01)，while change of serum IL6 was not obvious(P>0.05).Serum IL6，IL8 and TNFα levels of the treatment group were significantly lower than those of the control group(P<0.01)，which suggested that the improvement of immune injury in the treatment group was better.
ConclusionRevascularization therapy for TAO has better effect in improving clinical symptoms and inflammatory cytokine dysfunction than pure treatment with Western medicine，it lays a foundation for improving the clinical curative effect.
【Key words】revascularization；TAO；inflammatory cytokines；bloodstasis obstruction
血栓闭塞性脉管炎(Thromboangiitis obliterans，TAO)是由于血管壁全层炎症引起的中小动脉闭塞，累及邻近靜脉和神经的进行性、节段性、非感染性血管损害疾病，其病理变化主要是病变的血管出现继发腔内炎症细胞浸润性血栓、管腔闭塞和机化[1]。临床上以下肢多见，早期表现为间歇性跛行，晚期表现为严重静息痛、肢端溃疡和变黑坏死，最终需高位截肢[2]。TAO病因尚不完全明确，疗效欠佳[3]。为探讨血管重建对TAO的疗效，我们选取有介入治疗指征的下肢TAO患者18例用血管腔内介入加西药治疗，并与31例单纯用西药治疗的TAO患者进行对照，现总结报告如下。, http://www.100md.com(曾德创 邹才华 李近都 陈宏明 罗世官 李天资 唐习强 梁烨)