Özcan S, Tezcan O, Kurt T, Türköne H, Karahan O, Çalişkan A T, Adam G
Department of Cardiovascular Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey -
Int Angiol. 2015 Dec;34(6):576-81. Epub 2015 Mar 20.
Recurrent varicose veins are a frustration for both the patient and the surgeon. More investigation of the exact diagnosis, proper practice, and causes for the recurrence of varicose veins is needed.
We investigated a total number of 187 patients in a five year period with an estradiol-2/free testosterone (E2/fT) ratio relationship on recurrent varicose veins in men between the ages of 20-50. Fifity years was the maximum age due to the age dependent sex steroid hormone regression that occurs after this age, which may interefere with the assessment. Fifty three men with an elevated E2/fT ratio (group A), and 143 men with no endocrinologic problems (group B) were enrolled in the study and had surgery for varicose veins. After 5 years follow up (mean 3 years), Group A (N.=29) and group B (N.=43) had recurrent varicose veins by clinical and radiologic findings. Venous blood samples were driven from all patients of both groups in the morning to detect the levels of serum E2 and fT levels. Patient history of surgery for varicose veins, physical examination, color duplex ultrasound of both limbs, and classification of CEAP were performed in both groups.
The serum E2/fT ratio was significantly higher in Group A (5.21 ± 0.56) compared to group B (2.54±0.27) in the recurrent varicose vein groups (p ≤ 0.05). Moreover, there was a high correlation between serum E2/fT ratio and the CEAP clinical classification in group A (5) compared to group B (2) (P≤0.05). Also, recurrence rate was higher in group A (54%) compared to group B (32%)(P≤0.05).
Elevated serum E2/fT ratio is a precipitating factor for recurrent varicose veins in male patients.
复发性静脉曲张对患者和外科医生来说都是一件令人沮丧的事情。需要对静脉曲张的确切诊断、正确治疗方法以及复发原因进行更多研究。
我们在五年期间共调查了187例年龄在20至50岁之间男性复发性静脉曲张患者的雌二醇-2/游离睾酮（E2/fT）比值关系。由于50岁后会出现与年龄相关的性类固醇激素衰退，这可能会干扰评估，所以将50岁作为最大年龄。53例E2/fT比值升高的男性（A组）和143例无内分泌问题的男性（B组）纳入研究并接受了静脉曲张手术。经过5年随访（平均3年），根据临床和影像学检查结果，A组（n = 29）和B组（n = 43）出现了复发性静脉曲张。两组所有患者均于早晨采集静脉血样，以检测血清E2和fT水平。两组均进行了静脉曲张手术患者病史、体格检查、双下肢彩色超声检查以及CEAP分级。
在复发性静脉曲张组中，A组（5.21±0.56）的血清E2/fT比值显著高于B组（2.54±0.27）（p≤0.05）。此外，与B组（2）相比，A组（5）的血清E2/fT比值与CEAP临床分级之间存在高度相关性（P≤0.05）。而且，A组的复发率（54%）高于B组（32%）（P≤0.05）。
血清E2/fT比值升高是男性患者复发性静脉曲张的一个诱发因素。
