Analysis of clinical effects, inflammatory stress and immune cell levels in patients with acute aortic dissection after TEVAR / 中国医师杂志

ABSTRACT

Objective:To investigate the clinical effects, inflammatory stress and immune cell levels of patients with acute aortic dissection (AD) after thoracic aortic endovascular repair (TEVAR).Methods:A retrospective analysis of 60 patients with acute aortic dissection admitted to our hospital from April 2014 to January 2016 were divided into conservative group ( n=30) and TEVAR group ( n=30) according to different treatment methods. The conservative group was given drug therapy, and the TEVAR group was given a thoracic aortic endovascular repair therapy. The inflammatory cytokines and immune cell levels of the two groups were measured before and after treatment. The therapeutic effects and the long-term effects of the two groups were analyzed. Results:Before treatment, there was no significant difference in serum interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α) levels between the two groups ( P>0.05). After treatment, the levels of inflammatory cytokines in the two groups were significantly lower than those before treatment ( P<0.05); The levels of IL-6, IL-8 and TNF-α in the TEVAR group were significantly lower than those in the conservative group ( P<0.05). Before treatment, there was no significant difference in white blood cell count, neutrophil count, lymphocyte count and monocyte count between the two groups ( P>0.05). After treatment, the number of white blood cells and neutrophils decreased significantly in the two groups; and the number of lymphocytes in the two groups was significantly increased ( P<0.05). The number of white blood cells and neutrophils in the TEVAR group was significantly lower than that in the control group, and the number of lymphocytes was significantly higher than that in the conservative group ( P<0.05). The effective rate of the TEVAR group was significantly higher than that of the conservative group ( P<0.05). There was no significant difference in hospital mortality, hospitalization time and hospitalization complication between the two groups ( P>0.05). The 2-year survival rate of the TEVAR group was significantly higher than that of the conservative group. The postoperative complication rate was significantly lower than the conservative group ( P<0.05). There was no significant difference in the 1-year survival rate and secondary intervention rate between the two groups ( P>0.05). Conclusions:TEVAR has a better therapeutic effect, and improve survival rate to some extent.