腰交感神经毁损术对股骨头缺血性坏死患者微循环和血管活性物质的作用

摘要

目的:观察腰交感神经损毁术(LS)对股骨头缺血性坏死(ANFH)患者微循环和血管活性物质水平的影响.方法:运用LS治疗20例ANFH,观察治疗前后患者足甲襞微循环、血浆内皮素(ET)和降钙素基因相关肽(CGRP)、血栓素B2(TXB2)和6-酮-前列腺素(6-Keto-PGF1a)的水平变化,并与20例健康体检者进行比较.结果:与治疗前比较,ANFH患者治疗后足甲襞微循环各项积分、ET和TXB2含量均明显下降,CGRP和6-Keto-PGF1a含量均明显上升(P均<0.01),接近正常值水平.结论:LS能有效改善ANFH微循环障碍,纠正ANFH患者血管活性物质的代谢失衡,有利于改善股骨头的缺血缺氧状态.%Objective: To observe the effect of lumbar sympathectomy (LS) on toe nailfold microcirculation and four vasoactive substances in patients with avascular necrosis of femoral head (ANFH). Method: 20 patients with ANFH was treated with LS, and the changes of toe nailfold micro-circulation and contents of ET, CGRP, TXB2 and 6-Keto-PGF1a were detected before and after treatment, and they were compared with 20 healthy subjects. Results: After treatment, each score of nailfold micro-circulation and the contents of ET and TXB2 dropped, but the contents of CGRP and 6-Keto-PGF1a increased. The above scores and contents were close to normal levels and had highly significant differences (P<0. 01) than those before treatment. Conclusion: LS can effectively and significantly improve microcirculation disturbance and metabolic imbalance of vasoactive substances in patients with ANFH, which is beneficial to the improvement of ischemia and hypoxia of the femoral head.