血管重建术治疗血栓闭塞性脉管炎患者的疗效观察

Clinical observation of revascularization for patients with thromboangiitis obliterans

目的探讨血管重建术治疗血栓闭塞性脉管炎(TAO)患者临床治疗效果。方法选取有介入治疗指征的下肢TAO患者18例为治疗组,用血管重建术加西药治疗;选取同期单纯用西药治疗的TAO患者31例为对照组,两组疗程均为3个月。比较两组患者治疗效果,观察治疗前后两组患者血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)的变化情况。结果两组治疗效果比较差异无统计学意义(P>0.05)。治疗前两组血清IL-6、IL-8和TNF-α水平比较差异无统计学意义(P>0.05)。治疗后,治疗组血清IL-6、IL-8和TNF-α显著降低(P<0.01);对照组血清IL-8和TNF-α水平显著降低(P<0.01),IL-6水平变化不大(P>0.05);治疗组IL-6、IL-8和TNF-α均显著低于对照组(P<0.01)。提示治疗组对患者免疫损伤的改善作用优于对照组。结论血管重建术治疗TAO对改善患者的临床症状和炎症细胞因子功能紊乱的效果优于单纯西药治疗,为提高临床疗效奠定基础。

Objective To investigate the clinical effect of revascularization for patients with thromboangiitis obliterans（TAO）.Methods 18 cases of lower extremity TAO with indications of interventional therapy and treated with revascularization＋Western medicine were selected as treatment group,and 31 cases who treated with Western medicine only during the same period were selected as control group.Both groups were treated for 3 months.Then,the therapeutic effects of the two groups were compared,and the changes of serum interleukin-6（IL-6）,interleukin-8 （IL-8） and tumor necrosis factor-α（TNF-α） were observed before and after treatment.Results Difference of the therapeutic effects between the two groups was not statistically significant（P〉0.05）.Before treatment,difference of serum IL-6,IL-8 and TNF-α levels was not statistically significant（P〉0.05）.After treatment,however,serum IL-6,IL-8 and TNF-α levels of the treatment group significantly decreased（P〈0.01）,and serum IL-8 and TNF-α levels of the control group significantly decreased（P〈0.01）,while change of serum IL-6 was not obvious（P〉0.05）.Serum IL-6,IL-8 and TNF-α levels of the treatment group were significantly lower than those of the control group（P〈0.01）,which suggested that the improvement of immune injury in the treatment group was better.Conclusion Revascularization therapy for TAO has better effect in improving clinical symptoms and inflammatory cytokine dysfunction than pure treatment with Western medicine,it lays a foundation for improving the clinical curative effect.