血管重建术治疗血栓闭塞性脉管炎患者的疗效观察

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1、血管重建术治疗血栓闭塞性脉管炎患者的疗效观察【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a(TNFa)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TNFa水平比较差异无统计学意义(P>0・05)。治疗后，治疗组血清I

2、L6、IL8和TNFa显著降低(P0.05)；治疗组IL6、IL8和TNFa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]ObjectiveToinvostigatotheclinicaleffectofrevasc

3、ularizationforpatientswiththromboangiitisobliterans(TAO)•Methodsl8casesoflowerextremityTAOwithindicationsofinterventionaltherapyandtreatedwithrevascularization+Westernmedicinewereselectedastreatmentgroup,and31caseswhotreatedwithWesternmedicineonlyduringthesameperiodwereselect

4、edascontrolgroup.Bothgroupsweretreatedfor3months.Then，thetherapeuticeffectsofthetwogroupswerecompared,andthechangesofseruminterleukin6(IL6),interleukin8(IL8)andtumornecrosisfactora(TNFa)wereobservedbeforeandaftertreatment.ResultsDifferenceofthetherapeuticeffectsbetweenthetwog

5、roupswasnotstatisticallysignificant(P>0.05).Beforetreatment,differeneeofserumTI6TL8andTNFa1evelswasnotstatisticallysignificant(P>0.05)・Aftertreatment,however,serumIL6,IL8andTNFalevelsofthetreatmentgroupsignificantlydecreased(P0.05)・SerumIL6,IL8andTNFalevelsofthetreatmentgroup

6、weresignificantlylowerthanthoseofthecontrolgroup(P<0.01),whichsuggestedthattheimprovementofimmuneinjuryinthetreatmentgroupwasbetter・ConclusionRevascularizationtherapyforTAOhasbettereffectinimprovingclinicalsymptomsandinflammatorycytokinedysfunctionthanpuretreatmentwithWestern

7、medicine,itlaysafoundationforimprovingtheclinicalcurativeeffect.[Keywords】revascularization；TAO；inflammatorycytokines；bloodstasisobstmction血栓闭塞性脉管炎(Thromboangiitisobliterans,TAO)是由于血管壁全层炎症引起的中小动脉闭塞，累及邻近?。脉和神经的进行性、节段性、非感染性血管损害疾病，其病理变化主耍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

8、，早期表现为间歇性跛行，晩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］。TA0病因尚不完全明确，疗效欠佳［3］。为探讨血