Odegård A, Lundbom J, Myhre H O, Hatlinghus S, Bergh K, Waage A, Bjerve K S, Mollnes T E, Aadahl P, Lie T A, Videm V
Department of Radiology, Regional Hospital of Trondheim, Norway.
Eur J Vasc Endovasc Surg. 2000 May;19(5):536-44. doi: 10.1053/ejvs.1999.1092.
to compare the inflammatory response following endovascular and conventional AAA repair.
prospective study.
ten patients were selected for open surgery (OPEN) and ten for endovascular (ENDO) AAA repair. Leukocytes, platelets, myeloperoxidase, lactoferrin, beta-thromboglobulin, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-alpha) and complement activation products were measured before, during and after surgery.
in the OPEN group the median hospital stay was longer (6 vs. 12 days, p=0.001) and more patients required transfusion (p=0.02). IL-6 and CRP increased postoperatively, most in OPEN (p<0.01). Platelet counts decreased after the first angiography in ENDO (p<0.01) and before aortic cross-clamping in OPEN (p<0.05). The decrease was larger in OPEN (p=0.02). Leukocyte counts decreased after the first angiography in ENDO, and thereafter increased (p=0.001). An equivalent increase was observed in OPEN after declamping (p=0.001). Leukocyte and platelet degranulation products increased after the first angiography in ENDO and after declamping in OPEN. Changes in complement activation products were small. TNF-alpha did not change significantly.
endovascular AAA repair caused significant leukocyte and platelet activation. Based on the timing of activation this could be caused by radiographic contrast media.
比较血管内修复术和传统腹主动脉瘤修复术后的炎症反应。
前瞻性研究。
选择10例患者进行开放性手术（OPEN），10例进行血管内（ENDO）腹主动脉瘤修复术。在手术前、手术期间和手术后测量白细胞、血小板、髓过氧化物酶、乳铁蛋白、β-血小板球蛋白、C反应蛋白（CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）和补体激活产物。
OPEN组的中位住院时间更长（6天对12天，p = 0.001），更多患者需要输血（p = 0.02）。IL-6和CRP术后升高，OPEN组升高最为明显（p < 0.01）。ENDO组在第一次血管造影后血小板计数下降（p < 0.01），OPEN组在主动脉交叉阻断前血小板计数下降（p < 0.05）。OPEN组下降幅度更大（p = 0.02）。ENDO组在第一次血管造影后白细胞计数下降，之后升高（p = 0.001）。OPEN组在松开阻断后观察到类似的升高（p = 0.001）。ENDO组在第一次血管造影后以及OPEN组在松开阻断后白细胞和血小板脱颗粒产物增加。补体激活产物变化较小。TNF-α无明显变化。
血管内腹主动脉瘤修复术引起显著的白细胞和血小板激活。基于激活的时间，这可能是由放射造影剂引起的。
