Kodama Akio, Komori Kimihiro, Koyama Akio, Sato Tomohiro, Ikeda Shuta, Tsuruoka Takuya, Kawai Yohei, Niimi Kiyoaki, Sugimoto Masayuki, Banno Hiroshi, Nishida Kazuki
Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University School of Medicine.
Department of Vascular Surgery, Ichinomiya Municipal Hospital.
Circ J. 2022 May 25;86(6):995-1006. doi: 10.1253/circj.CJ-21-0832. Epub 2022 Mar 26.
Zinc (Zn) has been reported to play an important role in wound healing (WH). Nevertheless, the effect of Zn in chronic limb-threatening ischemia (CLTI) patients is unclear. This study investigated the effect of Zn on the clinical outcomes of CLTI patients undergoing bypass surgery.
This study reviewed 111 consecutive patients who underwent an infrainguinal bypass from 2012 to 2020. Patients with Zn deficiency (serum Zn level <60 μg/dL) received oral Zn supplementation and maintained a normal level until WH. This study aimed to explore: (1) the effect of Zn deficiency; and (2) Zn supplementation in Zn-deficient patients on the clinical outcomes of this cohort. Patients with Zn deficiency, Zn supplementation, and no Zn supplementation despite Zn deficiency accounted for 48, 21, and 42 patients, respectively. (1) Zn deficiency was associated with WH (HR, 0.47; 95% CI, 0.29-0.78: P=0.003), major adverse limb events (MALE) (HR, 2.53; 95% CI, 1.26-5.09: P=0.009), and major amputation or death (HR, 3.17; 95% CI, 1.51-6.63: P=0.002). (2) Zn supplementation was positively related to WH (HR, 2.30; 95% CI, 1.21-4.34: P=0.011). This result was confirmed using propensity score matching (HR, 2.24; 95% CI, 1.02-4.87: P=0.043).
The current study revealed that Zn level was associated with clinical outcomes in CLTI patients after bypass surgery. Oral Zn supplementation could improve WH in these patients.
据报道，锌（Zn）在伤口愈合（WH）中起重要作用。然而，锌对慢性肢体威胁性缺血（CLTI）患者的影响尚不清楚。本研究调查了锌对接受搭桥手术的CLTI患者临床结局的影响。
本研究回顾了2012年至2020年连续接受腹股沟下搭桥手术的111例患者。锌缺乏（血清锌水平<60μg/dL）的患者接受口服锌补充剂，并维持正常水平直至伤口愈合。本研究旨在探讨：（1）锌缺乏的影响；（2）锌缺乏患者补充锌对该队列临床结局的影响。锌缺乏、补充锌以及尽管锌缺乏但未补充锌的患者分别有48例、21例和42例。（1）锌缺乏与伤口愈合（HR，0.47；95%CI，0.29 - 0.78：P = 0.003）、严重肢体不良事件（MALE）（HR，2.53；95%CI，1.26 - 5.09：P = 0.009）以及大截肢或死亡（HR，3.17；95%CI，1.51 - 6.63：P = 0.002）相关。（2）补充锌与伤口愈合呈正相关（HR，2.30；95%CI，1.21 - 4.34：P = 0.011）。使用倾向评分匹配法证实了这一结果（HR，2.24；95%CI，1.02 - 4.87：P = 0.043）。
当前研究表明，锌水平与CLTI患者搭桥手术后的临床结局相关。口服补充锌可改善这些患者的伤口愈合情况。
