Parshakov Aleksey, Zubareva Nadezhda, Podtaev Sergey, Frick Peter
Aleksey Parshakov, PhD, is Assistant Professor, and Nadezhda Zubareva, PhD, is Professor, General Surgery Department, State Medical University, Institute of Continuous Media Mechanics, Perm, Russia. Sergey Podtaev, PhD, is Research and Development Director, FM Diagnostics, LLC, BioMedical Engineering Research Centre, and Research Scientist, Institute of Continuous Media Mechanics, Perm, Russia. Peter Frick, PhD, is Head of the Laboratory, Institute of Continuous Media Mechanics, Perm, Russia.
Adv Skin Wound Care. 2017 Apr;30(4):158-166. doi: 10.1097/01.ASW.0000508635.06240.c9.
In this study, authors used a wavelet analysis of skin temperature (WAST) to assess the mechanisms of microvascular tone regulation during the local heating test in patients with diabetic foot syndrome (DFS).
The participants included control subjects and 36 hospitalized patients with DFS between 52 and 79 years old (68 ± 8 years old). They were distributed among 5 groups: 15 control subjects, 8 patients with DFS who did not develop ulcerative or necrotic disorders, 10 patients who developed the neuroischemic form of DFS complicated by foot ulceration, 12 patients with DFS complicated by toe necrosis, and 6 patients with DFS and foot gangrene.
A comparison among the groups was made using a nonparametric Mann-Whitney U test. Spearman correlation coefficients were used to assess the relationship between WAST results, aortoarteriography, and ultrasonic dopplerography data.
In control subjects, a local increase in temperature (up to 42° C) causes a more than 3-fold increase in the amplitude of foot skin temperature oscillations. In patients with DFS, the response to the local heating test was much weaker. High correlations of WAST results to arterial patency of the lower extremities and the state of the vascular walls were established.
The WAST technique may have considerable value in evaluating the progression of DFS and the effectiveness of therapeutic interventions. The low cost of an individual test makes the WAST technique suitable for routine use in most healthcare facilities.
在本研究中，作者使用皮肤温度小波分析（WAST）来评估糖尿病足综合征（DFS）患者在局部加热试验期间微血管张力调节的机制。
参与者包括对照组和36名年龄在52至79岁之间（68±8岁）的住院DFS患者。他们被分为5组：15名对照受试者，8名未发生溃疡性或坏死性疾病的DFS患者，10名发生神经缺血型DFS并伴有足部溃疡的患者，12名伴有趾坏死的DFS患者，以及6名伴有足部坏疽的DFS患者。
使用非参数曼-惠特尼U检验对各组进行比较。使用斯皮尔曼相关系数评估WAST结果、主动脉造影和超声多普勒检查数据之间的关系。
在对照受试者中，局部温度升高（高达42°C）会导致足部皮肤温度振荡幅度增加超过3倍。在DFS患者中，对局部加热试验的反应要弱得多。WAST结果与下肢动脉通畅情况和血管壁状态之间建立了高度相关性。
WAST技术在评估DFS的进展和治疗干预的有效性方面可能具有相当大的价值。单次检测成本低，使得WAST技术适用于大多数医疗机构的常规使用。
