下肢深静脉血栓形成患者血浆白细胞介素-6、单核细胞黏附分子、肿瘤坏死因子-α在介入治疗前、后的变化及其临床意义

Change of plasma interleukin- 6, monocyte adhesion molecule and tumor necrosis factor- oL in patients with lower extremity deep venous thrombosis before and after interventional therapy and its clinical significance

目的观察下肢深静脉血栓形成（LEDVT）患者血浆白细胞介素-6（IL-6）、单核细胞黏附分子1（ICAM-1）、肿瘤坏死因子-a（TNF-α）在介入治疗前、后的变化并探讨炎症反应在下肢深静脉血栓形成中的作用。方法选取我院2014年9月至2016年2月就诊的LEDVT患者30例作为治疗组，同时选择拟诊下肢深静脉血栓形成但彩色多普勒超声检查下肢静脉正常者30例作为对照组。于介入治疗前测定所有人选患者IL-6、ICAM-1、TNF-α的水平，并在介入治疗1周后、3个月后再次测定治疗组患者上述指标的水平。结果治疗前，治疗组IL-6、ICAM-1、TNF-α水平高于对照组[（16．72±3．29）pg／L比（9．24±2．34）pg／L，（5．61±0．84）pmol／L比（1．90±0．17）pmol／L，（260．31±23．46）ng／L比（181．16±15．31）ng／L]，差异有统计学意义（P〈0．05）；治疗1周后，治疗组IL-6、ICAM-1、TNF-α水平较术前下降[（10．38±3．02）pgJ，L比（16．72±3．29）pg／L，（2．12±0．43）μmol／L比（5．61±0．84）μmol／L，（188．94±16．50）ng／L比（260．31±23．46）ng／L]，差异有统计学意义（P〈0．05），治疗3个月后，治疗组IL-6、ICAM-1、TNF-α水平无进一步下降[（10．43±3．07）pg／L比（10．38±3．02），（1．99±0．25）μmol／L比（2．12±0．43）gmol／L，（186．52±16．34）ng／L比（188．94±16．50）ng／L]，与治疗1周后水平比较差异无统计学意义（P〉0．05）。结论炎症因子表达上调可能在深静脉血栓形成中发挥了重要作用；检测介入术后血浆IL-6、ICAM-1、TNF—α水平可作为临床干预的可靠检测指标。

Objective To investigate the expression of plasma interleukin- 6 （IL- 6） , monocyte adhesion molecule-1 （ICAM-1） , tumor necrosis factor-α （TNF-ct） in patients with lower extremity deep venous thrombosis （LEDVT） before and after the interventional treatment, and to determine the effect of inflammatory response in LEDVT. Methods Thirty patients with LEDVT, who were hospitalized in our hospital between September 2014 and February 2016, were included in the study group. A contemporary cohort of 30 subjects, who were scheduled for the diagnosis of LEDVT with normal venous vein by Color Doppler ultrasound, was included in the control group. The levels of IL- 6, ICAM- 1 and TNF- α in the included patients were measured at the baseline, and the levels were measured again at 1 week and 3 months after the interventional treatment, respectively. Results At the baseline, the levels of IL-6, ICAM- 1 and TNF-a in the study group were significantly higher than those in the control group [ （16.72±3.29） pg/ L vs （9.24±2.34） pg/L, （5.61±0.84） μmol/L vs （1.90±0.17） μmol/L, （260.31±23.46） ng/L vs （181.16± 15.31 ng/L）], and the differences were statistically significant （P〈0.05）. At 1 week after the treatment, the levels of IL- 6, ICAM- 1 and TNF- a in the study group decreased significantly compared with those at the baseline [ （10.38±3.02） pg/L vs （16.72±3.29） pg/L, （2.12±0.43） μmol/ L vs （5.61±0.84） gmol/L, （188.94±16.50） ng/L vs （260.31±23.46） ng/L, and the differences were statistically significant （P〈0.05）. At 3 months after the treatment, the levels of IL-6, ICAM-1 and TNF-α in the study group did not decrease further [ （10.43±3.07） pg/L vs （10.38±3.02）, （1.99± 0.25） μmol/L vs （2.12±0.43） μmol/L, （186.52±16.34） ng/L vs （188.94±16.50） ng/L, and there were no significant differences compared with the levels at 1 week after the treatment （P〉0.05）. Conclusion The up-regulation of inflammatory factors may play an important role in LEDVT. The levels of plasma IL-6, ICAM-1 and TNF-a can be used as reliable indexes for clinical intervention after interventional treatment.