血栓闭塞性脉管炎患者病变血管壁中的巨细胞病毒DNA

目的：巨细胞病毒广泛存在,人和动物感染后可导致多种血管疾病,血栓闭塞性脉管炎,作为一种血管疾病,其病因未明,本研究的目的在于考察该病与巨细菌病毒感染的相关性,方法：为了考查血栓塞性脉管炎症变血管壁中巨细胞疾病DNA的存在,以PCR方法分析了41例该病血管壁标本和14例正常血管壁标本,引物基于该病毒即刻早期基因上游增强子的核壁标本,结果：41例病变血管标本中有28例（69．29％）发现巨细胞病毒核酸的存在,14例正常血管壁中有2例（14．29％）,两组间巨细胞病毒的感染率有统计学差异（P＜0．05）。结论：结果显示,在血栓塞性脉管炎病变血管中存在巨细胞病毒感染,它的感染可能与该病的发生和（或）发展有关。     

P-选择素在血栓闭塞性脉管炎内皮细胞中的表达

我们通过免疫组织化学的方法 ,选取正常青年人下肢小动脉作对照 ,选出在粘附分子家族中与血栓形成密切相关的粘附分子Ｐ 选择素 ,观察其在血栓闭塞性脉管炎内皮细胞中的表达情况 ,探讨对血栓闭塞性脉管炎中血栓形成的机理 ,现将结果报道如下。一、材料与方法1 .材料 :我院 1 975～ 1 985年经病理确诊为血栓闭塞性脉管炎的石蜡标本 1 1例。 1 2例正常小动脉对照标本来自 1 998年因外伤而下肢截肢的病人和第三军医大学解剖教研室。2 .免疫组织化学法 :第 1抗体为鼠抗人单抗 ,来自苏州医学院血栓病室 ,ＳＰ试剂盒来自福州迈新公司。ＳＰ法染色…     

血栓闭塞性脉管炎患者狼疮抗凝因子的研究

目的:研究脉管炎患者血中狼疮抗凝因子(LA)的存在情况并探讨该病的病因及病理特征.方法:采用激活部分凝血活酶时间(APTT)和鲁塞尔蝰蛇毒凝血时间(dRVVT)两种方法对31例脉管炎患者和20例正常对照作外周血LA的检测,结果:脉管炎患者LA阳性率为29%,明显高于正常对照组,按临床分期分组进行统计的结果表明Ⅱ期和Ⅲ期的LA阳性者明显高于Ⅰ期.结论:LA在血栓闭塞性脉管炎的病理性血栓发生过程中起着重要作用.     

巨细胞病毒所致婴幼儿下呼吸道感染及喘息的随访观察

目的通过分析巨细胞病毒与婴幼儿反复下呼吸道感染及喘息的关系,为婴幼儿喘息的病因和治疗提供一定的依据。方法对下呼吸道感染的婴幼儿进行巨细胞病毒抗体及DNA的检测,选择其中56例阳性的患儿,收集其临床表现特点、既往发病史、特异性体质的表现及家族史、实验室检查等,对其中41例予以抗病毒治疗。并对56例患儿进行2年的随访观察,比较抗病毒治疗与未经抗病毒治疗患儿的呼吸道感染次数及喘息发作的情况。结果巨细胞病毒可引起婴幼儿反复下呼吸道感染,并伴有喘息,重者可合并心力衰竭。41例抗病毒治疗患儿中有33例（80．5％）在随访中明显好转,15例未经抗病毒治疗的患儿7例（46．7％）有所好转,两者好转率比较差异有统计学意义（P〈0．05）。结论婴幼儿反复下呼吸道感染,尤其是喘息与巨细胞病毒感染关系密切,尽早做相应的检查和治疗,可减少喘息发作、改善预后。     

浸泡法与内服中药治疗血栓闭塞性脉管炎305例

浸泡法与内服中药治疗血栓闭塞性脉管炎３０５例株州市脉管炎研治所（湖南４１２００４）谢岳兴，谢宇霞血栓闭塞性脉管炎（ＴＡＯ），中医称为＂脱疽＂是常见的周围血管病，多发于青壮年男性。此病痛苦缠绵，难以根治，是世界性疑难病症。我所自１９８９年１月～１９９４...     

周围血管疾病病人血浆纤维结合蛋白的测定及意义

本文分析了周围血管疾病病人血浆纤维结合蛋白（Ｆｎ）的浓度和意义。Ｆｎ在深静脉血栓形成（ＤＶＴ）病人中的浓度较正常对照组显著降低（Ｐ＜０．０１）；在血栓闭塞性脉管炎（ＴＡＯ）、动脉闭塞性硬化症（ＡＳＯ）中稍有下降，无统计学意义（Ｐ＞０．０５）。结果表明ＤＶＴ病人Ｆｎ降低以血浆型Ｆｎ下降为主，主要是Ｆｎ产生减少和消耗增加；而Ｆｎ在ＴＡＯ、ＡＳＯ病人血浆中变化不显著，是否参与血管壁纤维化改变有待进一步研究     

血栓闭塞性脉管炎研究现况

血栓闭塞性脉管炎研究现况薛莲，张培华血栓闭塞性脉管炎（ＴＡＯ）是一种以中小动脉节段性、非化脓性炎症和腔内血栓形成为特征的疾病。１８７９年ＦｅｌｉｘｖｏｎＷｉｎｉｗａｒｔｅｒ报道了第１例患者，但直至１９０８年ＬｅｏＢｕｅｒｇｅｒ通过对１１例严重下肢缺血...     

胫骨骨搬运治疗血栓闭塞性脉管炎的疗效分析

[目的]探讨胫骨横向骨搬运技术治疗下肢血栓闭塞性脉管炎的有效性。[方法]对来本院治疗的52例血栓闭塞性脉管炎患者行胫骨横向骨搬运手术,术后50 d完成骨搬运,然后通过血管造影、肢体存活情况及随访观察评价疗效。[结果]52例中45例获得满意疗效,随访时间2~3年,肢体缺血坏死症状完全改善。7例术后仍有严重下肢缺血坏死,行下肢截肢术。总有效率为87%。[结论]胫骨横向骨搬运技术可以有效治疗下肢血栓闭塞性脉管炎,手术操作简单,安全有效,值得临床应用推广。     

中西医结合治疗下肢血栓闭塞性脉管炎效果观察

目的目的观察中西医结合治疗下肢血栓闭塞性脉管炎的临床效果。方法将60例下肢血栓闭塞性脉管炎患者随机分为2组,每组30例,对照组实施西医治疗,观察组在西医治疗的基础上联合中医治疗。比较2组临床治疗效果及不良反应。结果观察组治疗总有效率为93.33%,对照组为80.00%,2组差异有统计学意义(P0.05)。2组治疗过程中均未发生肝肾功能异常等不良反应。结论应用中西医结合治疗下肢血栓闭塞性脉管炎,可提高治疗效果,不良反应无明显增加。     

盐酸沙格雷酯治疗血栓闭塞性脉管炎的近期疗效

目的 观察盐酸沙格雷酯治疗血栓闭塞性脉管炎的近期疗效。方法 回顾性分析笔者所在医院2009年7月至2012年7月期间采用盐酸沙格雷酯治疗的28例血栓闭塞性脉管炎患者的临床资料,比较服药前后患者间歇性跛行距离、静息痛评分、冷感评分及溃疡面积的差异。结果 用药4周后,患者的无痛跛行距离〔（287±32） m比（167±28） m〕 和最长跛行距离 〔（315±40） m比（187±34） m〕 延长,静息痛得分（1分比2分）和冷感得分（1分比2分）降低,溃疡面积缩小〔（6.18±3.28） cm2比（10.06±4.25） cm2〕 ,差异均具有统计学意义（P＜0.05）。结论 盐酸沙格雷酯能改善血栓闭塞性脉管炎的缺血症状。     

HLA antigens in arterial occlusive diseases in Japan.

Using a NIH standard lymphocytotoxicity test, a possible Japanese specific HLA antigen, HLA-BJW 22.2 was identified in 17 out of 48 patients with thromboangiitis obliterans (35.4 per cent), in 5 out of 15 patients with Takayasu's arteritis (33.3 per cent) and in 11 out of 113 normal controls (9.7 per cent). On the other hand, HLA-CWl was found in 4 out of 47 patients with arteriosclerosis obliterans (8.5 per cent) and in 41 out of 113 normal controls (36.3 per cent).     

HLA antigens in arterial occlusive diseases in Japan

Using a NIH standard lymphocytotoxicity test, a possible Japanese specific HLA antigen, HLA-BJW 22.2, was identified in 17 out of 48 patients with thromboangiitis obliterans (35.4 per cent), in 5 out of 15 patients with Takayasu's, arteritis (33.3 per cent) and in 11 out of 113 normal controls (9.7 per cent). On the other hand, HLA-CWl was found in 4 out of 47 patients with arteriosclerosis obliterans (8.5 per cent) and in 41 out of 113 normal controls (36.3 per cent).     

Immunological studies in thromboangitis obliterans (Buerger's disease).

Immunological studies were carried out in 10 patients of thromboangiitis obliterans (Buerger's disease) and compared with controls. Cell mediated and humoral immunities were investigated. Presence of specific cellular immunity against arterial antigen, increased serum immunoglobulins, formation of specific humoral antiarterial antibodies, and demonstration of immune complexes raise the possibility of involvement of autoimmune process in causation of thromboangiitis obliterans.     

Revascularising osteotrepanation in treatment of lower limbs critical ischemia

The results of treatment of 202 patients with chronic critical ischemia of the extremities by the method of revascularising osteotrepanation are presented. There were 139 patients with atherosclerosis (AO) and 63 with thromboangiitis obliterans (TO). 69% of (AO) patients showed improvement of the circulation exactly after the operation 73%--in 1 year, 65%--in 3 years and 52%--in 5 years. In TO patients these percentases were--88%, 78%, 73%, 58%, respectively. It was established that the operation is most effective in TO and in distal forms of atherosclerosis. In occlusions of aorto-iliac segment it is indicated when rautine reconstruction procedure is impossible. In patients with severe and protracted painful syndrome unresponsive to narcotics, with "positional" oedemas and humid gangrene of the foot the operation is not advisable. Curative effect increases when revascularising osteotrepanation is combined with profundoplasty, sympathectomy, femoro-popliteal bypass grafting and devitalisation of the adrenal glands.     

69例急性下肢缺血的诊治分析

目的探讨急性下肢缺血的治疗方法及预后。方法回顾性分析我科2007年1月～2012年1月治疗69例急性下肢缺血患者的临床资料,其中急性动脉栓塞14例,动脉硬化闭塞基础上继发急性血栓形成50例,血栓闭塞性脉管炎3例,不明原因2例。根据病情采用:动脉切开Fogarty导管取栓8例,人工血管旁路17例;球囊扩张成形/支架置入15例;置管溶栓后进一步行腔内治疗12例;低位静脉动脉化2例;单纯药物治疗9例;I期截肢6例。结果 12例(17.4%)治疗成功,50例(72.5%)治疗好转,1例(1.4%)治疗无效。57例(82.6%)患者获得随访,随访时间3～62(平均26.4)个月,42例症状不同程度改善,7例Ⅱ期截肢,5例死于心、肺疾病。结论急性下肢缺血早期诊断与及时采用合适的治疗方法是治疗成功的关键。     

Lower limb ischemia in young adults: prognostic implications

Fifty patients (41 men and nine women) less than 36 years of age were evaluated for lower limb ischemia. Claudication was the presenting symptom in 30 patients (60%) and distal ulceration in 20 (40%). The mean age was 28.3 years. Premature atherosclerosis was present in 24 patients (48%) and thromboangiitis obliterans in 12 (24%). Other causes included a variety of unusual etiologies. Risk factors were analyzed. Twenty-two patients with claudication underwent arterial reconstruction; three had sympathectomy. Arterial reconstruction was possible in only three patients with ulceration; 17 had sympathectomy. No operative deaths or early amputations occurred. Follow-up averaged 13.5 years. Twenty-four patients with claudication were improved, three were unchanged, one developed ulceration, one required late amputation, and one was lost to follow-up. Four patients with ulceration were improved, one was unchanged, 14 required late amputation, and one was lost to follow-up. Ten patients, all with atherosclerosis obliterans, developed coronary artery disease; five died of myocardial infarction. No patient developed cerebrovascular disease. We conclude that reconstructive arterial surgery for claudication can be performed with low risk and a strong likelihood of long-term improvement. Most patients presenting with ulceration, however, will ultimately require amputation. Patients with atherosclerosis obliterans are at risk for coronary artery disease and death of myocardial infarction.     

分期动静脉转流治疗肢体动脉闭塞症176例

目的探讨分期动静脉转流术治疗血栓闭塞性脉管炎(TAO)和动脉硬化闭塞症的远期效果。方法回顾性分析176例分期动静脉转流术的临床资料。结果147例获随访,随访率83 5%,中位随访时间9 8年。6例上肢和84例下肢低位深组转流患者中, 86例(95 5% )术后1周疼痛消失,肢体保留率100%。57例下肢高位深组转流者中, 43例(75 4% )疼痛术后2 ~3周消失,术后5例截肢,截肢率8 8% (5 /57),肢体保留率91 2%。结论分期动静脉转流治疗TAO和广泛性动脉硬化闭塞症临床效果满意,但应严格掌握手术适应证。     

Surgical-drug therapy aspects of the treatment of patients with obliterating thromboangiitis of the lower limbs]

Standard operative interventions (thromboendarterectomy, (autovenous shunt) in patients with thromboangiitis obliterans of the lower limbs produce a poor effect. This is explained both by a poor initial condition of the draining channels and by advancement of the primary thromboangitic affection of the vascular wall in the zone of the intervention with its development into a stenotic-occlusive process. The use of some technical (operative) innovations, particularly postoperative arterial infusion of suspended forms of immunosuppresive agents (hydrocortisone, Kenalog), increased essentially the efficacy of restorative operations on the vessels with a high level of limb preservation and patency of the vessels which had been operated on.     

Preliminary application of the immunogold-silver staining technique in diagnosing thromboangiitis obliterans

In this paper we reported the preliminary application of immunogold-silver staining (IGSS) technique in immunopathological diagnosis of thromboangiitis obliterans (TAO). We used IGSS technique to detect the immune complexes deposit in the vascular walls (18 cases) and the anti-vascular autoantibody in serum (28 cases) of TAO patients. The immune complexes deposited in tissue were found in 100%, and the anti-vascular autoantibody in 86% of TAO patients. The results of IGSS technique were compared with that of immunofluorescent staining, immunoenzyme staining and avidin-biotin-peroxidase complex staining techniques. It was demonstrated that both the sensitivity and specificity of IGSS technique were significantly higher than those of other techniques.