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有症状的原发性静脉曲张的适当手术治疗可降低全身炎症生物标志物水平。

Appropriate Surgical Treatment of Symptomatic Primary Varicose Veins Decreases Systemic Inflammatory Biomarkers.

作者信息

Arase Hiroki, Sugasawa Noriko, Kawatani Youhei, Sugano Mikio, Kurobe Hirotsugu, Fujimoto Eiki, Kitaichi Takashi, Kitagawa Tetsuya

机构信息

Department of Cardiovascular Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan.

出版信息

Ann Vasc Dis. 2019 Sep 25;12(3):367-371. doi: 10.3400/avd.oa.19-00011.

Abstract

: To evaluate the relationship between systemic inflammatory biomarkers and efficacy of surgical treatment of primary varicose veins of the lower extremities. : Total 12 patients who underwent endovenous laser ablation or stripping of varicose veins and six healthy subjects were enrolled. Structural and molecular changes of varices were assessed by immunohistochemical staining with anti-monocyte chemotactic protein-1 (MCP-1). MCP-1 and interleukin-6 (IL-6) levels in systemic antecubital blood were measured before and at 12 weeks after treatment. : Immunohistochemical staining revealed prominent manifestation of MCP-1-positive endothelial cells in the walls of varices. Preoperative serum MCP-1 and IL-6 levels in the patients were significantly higher than those in the control (166±12 pg/mL vs 99±10 pg/mL, p=0.003; 5.1±0.95 pg/mL vs 0.0±0.0 pg/mL, p=0.001, respectively). The values were significantly correlated with the severity of chronic venous insufficiency (CVI). Postoperative serum MCP-1 level significantly decreased compared with the preoperative level (152±10 pg/mL vs 166±12 pg/mL, p=0.048). The values after endovenous laser ablation did not significantly decrease compared with those after stripping. : Varicose veins with CVI increase inflammatory biomarker levels in the local tissue and systemic blood. Appropriate treatment of symptomatic varicose veins decreases inflammatory biomarker levels.

摘要

评估全身炎症生物标志物与下肢原发性静脉曲张手术治疗疗效之间的关系。

共纳入12例行下肢静脉曲张腔内激光消融术或剥脱术的患者以及6名健康受试者。通过抗单核细胞趋化蛋白-1(MCP-1)免疫组织化学染色评估静脉曲张的结构和分子变化。在治疗前及治疗后12周测量全身肘前静脉血中MCP-1和白细胞介素-6(IL-6)水平。

免疫组织化学染色显示静脉曲张壁中MCP-1阳性内皮细胞显著表达。患者术前血清MCP-1和IL-6水平显著高于对照组(分别为166±12 pg/mL对99±10 pg/mL,p = 0.003;5.1±0.95 pg/mL对0.0±0.0 pg/mL,p = 0.001)。这些值与慢性静脉功能不全(CVI)的严重程度显著相关。术后血清MCP-1水平与术前水平相比显著降低(152±10 pg/mL对166±12 pg/mL,p = 0.048)。腔内激光消融术后的值与剥脱术后相比无显著降低。

伴有CVI的静脉曲张会增加局部组织和全身血液中的炎症生物标志物水平。对有症状的静脉曲张进行适当治疗可降低炎症生物标志物水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c60/6766771/00e2b18359ab/avd-12-3-oa.19-00011-figure01.jpg

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