Mennes Onno A, van Netten Jaap J, van Baal Jeff G, Slart Riemer H J A, Steenbergen Wiendelt
Biomedical Photonic Imaging, University of Twente, 7522 NB Enschede, The Netherlands.
Ziekenhuisgroep Twente, ZGT Academy, 7609 PP Almelo, The Netherlands.
J Clin Med. 2021 Aug 27;10(17):3844. doi: 10.3390/jcm10173844.
Diagnosis of peripheral artery disease in people with diabetes and a foot ulcer using current non-invasive blood pressure measurements is challenging. Laser speckle contrast imaging (LSCI) is a promising non-invasive technique to measure cutaneous microcirculation. This study investigated the association between microcirculation (measured with both LSCI and non-invasive blood pressure measurement) and healing of diabetic foot ulcers 12 and 26 weeks after measurement. We included sixty-one patients with a diabetic foot ulcer in this prospective, single-center, observational cohort-study. LSCI scans of the foot, ulcer, and ulcer edge were conducted, during baseline and post-occlusion hyperemia. Non-invasive blood pressure measurement included arm, foot, and toe pressures and associated indices. Healing was defined as complete re-epithelialization and scored at 12 and 26 weeks. We found no significant difference between patients with healed or non-healed foot ulcers for both types of measurements ( = 0.135-0.989). ROC curves demonstrated moderate sensitivity (range of 0.636-0.971) and specificity (range of 0.464-0.889), for LSCI and non-invasive blood pressure measurements. Therefore, no association between diabetic foot ulcer healing and LSCI-measured microcirculation or non-invasive blood pressure measurements was found. The healing tendency of diabetic foot ulcers is difficult to predict based on single measurements using current blood pressure measurements or LSCI.
使用当前的非侵入性血压测量方法诊断糖尿病足溃疡患者的外周动脉疾病具有挑战性。激光散斑对比成像（LSCI）是一种很有前景的用于测量皮肤微循环的非侵入性技术。本研究调查了测量后12周和26周时微循环（通过LSCI和非侵入性血压测量）与糖尿病足溃疡愈合之间的关联。在这项前瞻性、单中心、观察性队列研究中，我们纳入了61例患有糖尿病足溃疡的患者。在基线期和阻断后充血期对足部、溃疡及溃疡边缘进行LSCI扫描。非侵入性血压测量包括手臂、足部和脚趾血压以及相关指数。愈合定义为完全重新上皮化，并在12周和26周时进行评分。我们发现，对于这两种测量类型，足部溃疡愈合或未愈合的患者之间没有显著差异（ = 0.135 - 0.989）。ROC曲线显示，LSCI和非侵入性血压测量的敏感性中等（范围为0.636 - 0.971），特异性中等（范围为0.464 - 0.889）。因此，未发现糖尿病足溃疡愈合与LSCI测量的微循环或非侵入性血压测量之间存在关联。基于当前的血压测量或LSCI单次测量，很难预测糖尿病足溃疡的愈合趋势。
