激光光凝治疗大隐静脉曲张围手术期TNF-α和IL-6的水平  

Changes of Plasma IL-6 and TNF-α Levels During Peri-Operative Period in Patients Undergoing Laser Photo-Coagulation of Greater Saphenous Varicosities

作　　者：王太晗[1] 王春喜[2] 

机构地区：[1]济宁市计生委,天津医科大学临床医学博士生272100 [2]中国人民解放军总医院,100853

出　　处：《放射免疫学杂志》2005年第6期412-414,共3页Journal of Radioimmanology

摘　　要：目的:检测血管内光凝治疗大隐静脉曲张围手术期血浆白细胞介素-6(IL-6)和肿瘤坏死因子α(TNF-α)的水平。方法:大隐静脉曲张患者110例,其中行血管内激光光凝治疗者43例,行静脉瓣膜环包联合血管内光凝者35例,行大隐静脉高位结扎、分段剥脱治疗者32例。110例患者中有明显皮肤营养障碍者56例。在治疗前及治疗后1,3,7,14d取静脉血,采用放射免疫分析检测血浆内IL-6和TNF-α的水平。另外取正常献血者33例作为对照。结果:皮肤正常大隐静脉曲张患者较正常血浆IL-6和TNF-α水平没有明显改变,而伴有明显皮肤营养障碍和血栓形成患者IL-6和TNF-α皆高于正常。三种术式进行治疗围手术期IL-6和TNF-α均呈现先升高后降低,最后恢复至正常水平的趋势。IL-6和TNF-α水平变化幅度由小到大和恢复到正常水平的顺序为血管内激光光凝治疗组、静脉瓣膜环包联合血管内光凝、大隐静脉高位结扎、分段剥脱治疗组。结论:血浆IL-6和TNF-α水平高低是判断治疗大隐静脉曲张不同手术方式的应激强度大小和病程转归的一种指标。Objective To investigate the plasma levels of IL - 6 and TNF - α during peri - operative period in patients undergoing laser photocoagution of greater saphenous varicosities. Methods Plasma IL - 6 and TNF - α levels were determined with RIA before operation and 1, 3, 7, 14 days post - operatively in 110 patients with greater saphenous vein varicosity undergoing different forms of treatment （ intravascular laser photo - coagulation 43, photo - coagulation combined with venous valve repair 35, high ligation and segmental stripping 32 ）. Skin trophic disturbances were present in 56 of the 110 patients. Plasma IL - 6 and TNF - α levels were also measured in 33 controls. Results The plasma IL -6 and TNF -α levels in patients with skin trophic disturbances were significantly higher than those in controls （P 〈 0.01 ） , while levels in patients without skin lesions were not much changed. The plasma IL- 6 and TNF - α levels were increased at first and dropped later to approaching pre - operative value by d14 in all the 110 patients after operation, however, the amount of increase was least and the normalization was also soonest in the simple photo - coaguation group, the reverse was true for the conventional operation group. Conclusion Laser photo - coagulation is least stressful among the three types of operation and magnitude of changes of plasma IL - 6 and TNF - α levels correctly reflects the intensity of stress.

关 键 词：大隐静脉曲张 光凝 白细胞介素-6 肿瘤坏死因子-Α 激光光凝治疗 

分 类 号：R543.6[医药卫生—心血管疾病] R654[医药卫生—内科学]