Blood Hernia Minimally Invasive Surgery Ward, Xuzhou Central Hospital, Xuzhou, China.
Interventional Minimally Invasive Surgery, Xuzhou Central Hospital, Xuzhou, China.
Ann Palliat Med. 2022 Aug;11(8):2720-2729. doi: 10.21037/apm-22-827.
Lower extremity arteriosclerosis obliterans (LEASO) is a chronic progressive disease with clinical manifestations such as intermittent claudication, resting pain, and even ulceration or necrosis of the lower extremities caused by insufficient blood supply to the diseased limbs. This study aimed to evaluate the effect of diabetes on the prognosis of LEASO patients after the percutaneous transluminal angioplasty (PTA) treatment.
The clinical data of LEASO patients who received PTA treatment in the Blood Hernia Minimally Invasive Surgery Ward of Xuzhou Central Hospital from January 2017 to December 2021 were retrospectively analyzed. The patients were divided into a diabetic group and a non-diabetic group. The general data, lesion location, technical and clinical success rates, changes in the ankle-brachial index (ABI) and serum inflammatory factors, perioperative complications, resting pain relief rate, amputation rate, and quality of life of the two groups were compared.
A total of 223 LEASO patients (256 limbs) were included, including 78 patients with diabetes (91 limbs) and 145 patients without diabetes (165 limbs). Compared with the non-diabetic group, the proportion of lesions in the superior genicular artery was lower, and that in the inferior genicular artery was higher in the diabetic group (P<0.05). Compared with the diabetic group, the levels of serum inflammatory factors in the non-diabetic group were significantly lower than those in the diabetic group, while the clinical success rate was markedly higher (P<0.05). Moreover, the body pain, general health, and mental health scores of the non-diabetic group were considerably higher than those of the diabetic group patients. Logistic regression analysis showed that the odds ratio (OR) values of Rutherford stage, diabetes and C-reactive protein (CRP) level were 20.124, 44.893 and 14.523 respectively, P<0.05, which were independent factors affecting clinical success.
PTA to treat diabetic patients with LEASO can achieve short-term efficacy similar to that of non-diabetic patients. However, the long-term clinical success rate and quality of life of diabetes patients are still inferior to those of non-diabetic patients. Standardized postoperative anti-inflammatory treatment and blood glucose control are crucial for long-term efficacy.
下肢动脉硬化闭塞症（LEASO）是一种慢性进行性疾病，临床表现为间歇性跛行、静息痛，甚至因病变肢体供血不足而出现溃疡或坏死。本研究旨在评估糖尿病对经皮腔内血管成形术（PTA）治疗后 LEASO 患者预后的影响。
回顾性分析 2017 年 1 月至 2021 年 12 月在徐州中心医院血透微创外科病房接受 PTA 治疗的 LEASO 患者的临床资料。将患者分为糖尿病组和非糖尿病组。比较两组一般资料、病变部位、技术和临床成功率、踝肱指数（ABI）和血清炎症因子变化、围手术期并发症、静息疼痛缓解率、截肢率和生活质量。
共纳入 223 例 LEASO 患者（256 条肢体），其中糖尿病患者 78 例（91 条肢体），非糖尿病患者 145 例（165 条肢体）。与非糖尿病组相比，糖尿病组膝关节上动脉病变比例较低，膝关节下动脉病变比例较高（P<0.05）。与糖尿病组相比，非糖尿病组血清炎症因子水平明显较低，临床成功率明显较高（P<0.05）。此外，非糖尿病组患者的身体疼痛、一般健康和心理健康评分明显高于糖尿病组。Logistic 回归分析显示，Rutherford 分期、糖尿病和 C 反应蛋白（CRP）水平的比值比（OR）值分别为 20.124、44.893 和 14.523，P<0.05，均为影响临床成功率的独立因素。
PTA 治疗 LEASO 合并糖尿病患者可获得与非糖尿病患者相似的短期疗效，但糖尿病患者的长期临床成功率和生活质量仍低于非糖尿病患者。规范化的术后抗炎治疗和血糖控制对长期疗效至关重要。
