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目的研究下肢静脉高压对局部血清黏附分子含量的影响。方法经过双功彩超和静脉造影,选取单下肢慢性静脉功能不全(chronic venous insufficiency,CVI)的患者20例,在下肢静止下垂30min后分别抽取双下肢静脉血,同时取上肢静脉血作为对照组,而后取平卧位15min后再取双下肢静脉血。分为曲张静脉直立组(Vh组)、正常静脉直立组(Nh组)、曲张静脉平卧组(Vr组)、正常静脉平卧组(Nr组)和上肢对照组5组。用酶联免疫吸附法(ELISA)检测血清中的sICAM-1、sVCAM-1的含量。结果(1)Vh组和Nh组这两组静脉高压组的sICAM-1、sVCAM-1明显高于对照组(P<0.01),而Vh组和Nh组之间差异无统计学意义(P>0.05)。(2)Nr组和Nh组相比,sICAM-1、sVCAM-1均下降(P<0.05)。(3)Vr组和Vh组相比,sICAM-1、sVCAM-1无明显变化(P>0.05)。结论下肢静脉系统在血流淤滞和静脉高压的情况下,无论是否本身静脉有异常,局部的内皮细胞和白细胞均有激活并表达黏附分子。而在短时间静脉高压解除后,曲张静脉中局部的黏附分子高水平表达提示炎症仍持续,而正常静脉则有所下降。曲张静脉中炎症反应的持续性表达可能是CVI发展的重要环节。
Objective To study the effect of venous hypertension on the local serum adhesion molecules. Methods Twenty patients with chronic venous insufficiency (CVI) undergoing double color Doppler ultrasonography and venography were selected. Venous blood of both lower extremities was extracted from venous blood of both lower extremities after resting droop 30 minutes later, and venous blood of upper limb was taken as control group. Then take the supine position 15min and then take both lower extremity venous blood. Divided into varicose veins erection group (Vh group), normal vein erection group (Nh group), varicose vein supine group (Vr group), normal vein supine group (Nr group) and upper limb control group 5 groups. Serum levels of sICAM-1 and sVCAM-1 were detected by enzyme-linked immunosorbent assay (ELISA). Results (1) The sICAM-1 and sVCAM-1 levels in Vh group and Nh group were significantly higher than those in control group (P <0.01), but there was no significant difference between Vh group and Nh group (P> 0.05). (2) Compared with Nh group, sICAM-1 and sVCAM-1 decreased in Nr group (P <0.05). (3) Compared with Vh group, sICAM-1 and sVCAM-1 had no significant change in Vr group (P> 0.05). Conclusions In the case of blood stasis and venous hypertension in the lower extremity venous system, both local endothelial cells and leukocytes activate and express adhesion molecules whether or not there is an abnormal vein. In a short period of time after the release of intravenous hypertension, varicose veins in local high expression of adhesion molecules suggest that inflammation continues, while the normal vein decreased. Sustained expression of inflammatory responses in varicose veins may be an important link in the development of CVI.