腘静脉瓣膜病变在原发性下肢慢性静脉功能不全中的意义

Significance of valvular incompetence of popliteal vein in primary chronic venous insufficiency of lower extremities

目的:探讨腘静脉瓣膜病变对原发性下肢慢性静脉功能不全(PCVI)发病中的作用。方法:将符合纳入标准的268例PCVI患者资料,依据病变瓣膜位置分为隐股瓣膜病变组、股浅静脉瓣膜病变组、腘静脉瓣膜病变组、股腘静脉瓣膜病变组,每组67例,比较各组Kistner分级,病变静脉节段积分(VSDS),症状(C)分级,临床症状严重程度积分(VCSS),劳动能力丧失程度积分(VDS)的差异性。结果:腘静脉瓣膜病变组在Kistner分级,VSDS,C分级,VCSS,VDS方面均高于隐股瓣膜病变组及股浅静脉瓣膜病变组,差异均有统计学意义(均P<0.05),而低于腘静脉瓣膜病变组,部分差异有统计学意义(Kistner分级和VSDS)(均P<0.05)。病变瓣膜位置与Kistner分级的相关性有统计学意义(r=0.926,P=0.000),同时Kistner分级与C分级的相关性受性别、年龄、病程因素的影响(均P<0.05)。结论:腘静脉瓣膜病变能造成下肢静脉血液返流程度进一步加重、受累静脉范围进一步扩大,及临床症状加重、劳动能力降低。

Objective： To investigate the significance of the valvular venous insufficiency （PCVI） of the lower extremities. incompetence of the popliteal vein in primary chronic Methods： q-he data of 268 PCVI patients that met the inclusion criteria were divided, according to the lesions location, into sapheno-femoral valve incompetence group, superficial femoral vein valve incompetence group,popliteal vein valve incompetence group, and femoral-popliteal vein valve incompetence group, with 67 cases in each group. The differences in Kistner＇s classification, venous segmental disease score （VSDS）, clinical （C） classification, venous clinical severity score （VCSS） and venous disability score （VDS） among the groups were determined. Results： The Kistner＇s classification, VSDS, C classification, VCSS and VDS in popliteal vein valve incompetence group were all higher than those in sapheno-femoral valve incompetence group or superficial femoral vein valve incompetence group, with all differences achieving statistical significance （all P〈0.05）, but were all lower than those in femoral-popliteal vein valve incompetence group, with some differences reaching statistical significance （Kistner classification and VSDS） （both P〈0.05）. The correlation between lesion＇s location and Kistner＇s classification had statistical significance （r=0.926, P=0.000）, and the correlationship between Kistner＇s classification and C classification were affected by the factors such as sex, age, and course of disease （all P〈0.05）. Conclusion： Valvular incompetence of the popliteal vein can aggravate the venous reflux in lower limbs, expand the range of venous disease, exacerbate the clinical symptoms and decrease working ability.