下肢慢性靜脈功能不全發病機理的臨床研究_《中國普外基礎與臨床雜志》

作者：

喬正榮 , 時德

重慶醫科大學附屬第一醫院血管外科（重慶400016）;

關鍵詞：

靜脈功能不全粘附分子細胞因子

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目的探討下肢慢性靜脈功能不全（CVI）時細胞因子水平和粘附分子表達與皮膚損傷的關系。方法采用酶聯免疫吸附法（ELISA法）檢測血漿TNFα、IL1β和IL2R水平，免疫組織化學法（SP法）檢測血漿白細胞粘附分子（ECICAM1、PMNCD18及PMNCD11b）的表達，并在電鏡下觀察32例CVI患者和8例正常對照組下肢皮膚標本的超微結構改變。結果①CVI Class 2～3級血漿TNFα和IL1β水平分別為（194.66±221.90)pmol/L和（100.60±19.43）pmol/L，明顯高于對照組的（34.38±9.74）pmol/L和（67.62±17.20）pmol/L（P＜0.05），Class 2～3級和1級血漿IL2R水平分別為（149.79±85.77）pmol/L和（98.22±38.55）pmol/L，與對照組的（94.67±13.01）pmol/L相比較，差異無顯著性意義（P gt;0.05）； ②Class 2～3級ECICAM1、PMNCD18和PMNCD11b表達陽性率分別為（0.70±0.14）%、（0.12±0.03）%和（0.16±0.02）%，明顯高于對照組的（0.15±0.09）%、（0.04±0.01）%和（0.05±0.01）%(P＜0.05)； ③相關分析顯示ICAM1表達與CD11b和CD18表達呈顯著正相關，r值分別為0.845 4和0.563 9 (P＜0.05)； ④電鏡超微結構見中性粒細胞（PMN）與ECs粘附導致皮膚微血管病變。結論CVI下肢靜脈系統瘀血和高壓可能激活單核細胞分泌釋放TNFα、IL1β等細胞因子，上調ICAM1和CD11b/CD18表達，并介導PMN粘附于ECs，導致ECs和組織損傷，可能是靜脈潰瘍重要的發病機理之一。

引用本文： 喬正榮,時德. 下肢慢性靜脈功能不全發病機理的臨床研究. 中國普外基礎與臨床雜志, 2003, 10(3): 249-252. doi: 復制

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1. Porter J, Rutherford RB, Clagett G, et al. Reporting standards in venous disease [Ｊ]. J Vasc Surg, 1988; 8(2)∶172.
2. Fujita H, Morita I, Murota S. A possible mechanism for vascular endothelial cell injury elicited by activated leukocytes: a significant involvement of adhesion molecules, CD11/CD18, and ICAM1 [Ｊ]. Arch Biochem Biophys， 1994; 309(1)∶62.
3. Carlos TM, Harlan JM. Membrane proteins involved in phagocyte adherence to endothelium [Ｊ]. Immunol Rev, 1990; 114(2)∶5.
4. Makgoba MW, Bernard A, Sanders ME. Cell adhesion/signalling: biology and clinical applications [Ｊ]. Eur J Clin Invest, 1992; 22(7)∶443.
5. Bennett CF， Crook ST. Regulation of endothelial cell adhesion molecule expression with antisense oligonucleotides [Ｊ]. Adv Pharmacols, 1994; 28（1）∶1.
6. Claudy AL, Mirshahi M, Soria C, et al. Detection of undegraded fibrin and tumor necrosis factoralpha in venous leg ulcers [Ｊ]. J Am Acad Dermatol, 1991; 25(4)∶623.
7. Ksander GA, Sawamura SJ, Ogawa Y, et al. The effect of platelet releasate on wound healing in animal models [Ｊ]. J Am Acad Dermatol, 1990; 22(5 Pt 1)∶781.
8. Barath P, Fishbein MC, Cao J, et al. Detection and localization of tumor necrosis factor in human atheroma [Ｊ]. Am J Cardiol, 1990; 65(5)∶297.
9. Weyl A, Vanscheidt W, Weiss JM, et al. Expression of the adhesion molecules ICAM1, VCAM1, and Eselectin and their ligands VLA4 and LFA1 in chronic venous leg ulcers [Ｊ]. J Am Acad Dermatol, 1996; 34(3)∶418.

《中國普外基礎與臨床雜志》

下肢慢性靜脈功能不全發病機理的臨床研究

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《中國普外基礎與臨床雜志》

下肢慢性靜脈功能不全發病機理的臨床研究

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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