Kendler M, Kratzsch J, Wetzig T, Simon J C
Department of Dermatology, Venerology and Allergology, Leipzig University Medical Center, Leipzig, Germany
Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Medical Center, Leipzig, Germany.
Phlebology. 2014 Jun;29(5):310-7. doi: 10.1177/0268355513478586. Epub 2013 May 3.
The objective of this study was to assess differences in blood samples (sex steroid hormone levels and blood counts) before and after surgical treatment of incompetent great saphenous veins (GSV) in males.
Antecubital vein and GSV blood samples were taken from 11 men with varicose veins and GSV reflux before and after treatment. Six patients were treated with high ligation, stripping and phlebectomy. Five patients were treated with endoluminal radiofrequency ablation and phlebectomy. After a four-year follow-up period (FU) cubital vein and GSV blood samples were taken again.
In men with varicose veins, significantly higher (P < 0.05) serum testosterone (median 25.18 nmol/L, range 8.82-225.1) and oestradiol (median 179 pmol/L, range 79-941) levels were found in the saphenous vein samples before and after the FU (testosterone 18.8 nmol/L, range 7.96-83.1, oestradiol 171 pmol/L range 125-304) compared with the cubital vein samples before therapy (testosterone 15.72 nmol/L, range 8.36-23.29; oestradiol 84 pmol/L, range 41-147) and after the FU (testosterone 14.5 nmol/L, range 6.10-22.2, oestradiol 117 pmol/L, range 95-165). After the FU, one patient demonstrated recurrent varicose veins with groin neovascularization. Another presented with axial reflux of the anterior accessory saphenous vein. Further differences in blood counts and serum androstenedione levels between the upper and lower extremities were not detected.
The differences between testosterone and oestradiol levels in the leg veins compared with the cubital veins persist after treating men with refluxing saphenous veins. These results suggest that local hormone regulation may be different between leg and arm veins in men with varicose veins.
本研究的目的是评估男性大隐静脉功能不全手术治疗前后血液样本（性类固醇激素水平和血细胞计数）的差异。
从11名患有静脉曲张和大隐静脉反流的男性患者治疗前后采集肘静脉和大隐静脉血样。6例患者接受高位结扎、剥脱和静脉切除术治疗。5例患者接受腔内射频消融和静脉切除术治疗。经过四年的随访期后，再次采集肘静脉和大隐静脉血样。
在患有静脉曲张的男性中，与治疗前肘静脉血样（睾酮15.72 nmol/L，范围8.36 - 23.29；雌二醇84 pmol/L，范围41 - 147）以及随访后肘静脉血样（睾酮14.5 nmol/L，范围6.10 - 22.2，雌二醇117 pmol/L，范围95 - 165）相比，随访前后大隐静脉血样中血清睾酮（中位数25.18 nmol/L，范围8.82 - 225.1）和雌二醇（中位数179 pmol/L，范围79 - 941）水平显著更高（P < 0.05）。随访后，1例患者出现复发性静脉曲张伴腹股沟新生血管形成。另1例患者出现前副大隐静脉轴向反流。未检测到上下肢血细胞计数以及血清雄烯二酮水平的进一步差异。
在治疗有反流性大隐静脉的男性后，腿部静脉与肘静脉之间的睾酮和雌二醇水平差异仍然存在。这些结果表明，患有静脉曲张的男性腿部静脉和手臂静脉之间的局部激素调节可能不同。
