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糖尿病足综合征患者下肢动脉血管内血运重建术后血管生成和微血管状态改变:一项为期12个月的前瞻性随访研究

Angiogenic and Microvascular Status Alterations after Endovascular Revascularization of Lower Limb Arteries among Patients with Diabetic Foot Syndrome: A Prospective 12-Month Follow-Up Study.

作者信息

Schönborn Martyna, Gregorczyk-Maga Iwona, Batko Krzysztof, Maga Mikołaj, Bogucka Katarzyna, Gawlik Katarzyna, Pawlica-Gosiewska Dorota, Maga Paweł

机构信息

Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland.

Doctoral School of Medical and Health Sciences, Jagiellonian University, 31-007 Krakow, Poland.

出版信息

J Clin Med. 2023 Aug 27;12(17):5581. doi: 10.3390/jcm12175581.

Abstract

Peripheral arterial disease (PAD)-induced ischemia is an important component of diabetic foot syndrome (DFS). The results of revascularization of the lower extremity arteries (including percutaneous transluminal angioplasty [PTA]) do not always give satisfactory long-term results, which is due to many factors. The aim of the study was to investigate the alterations in selected circulating angiogenic factors and microcirculation parameters in 41 patients with DFS following PTA and analyze their relationships with clinical outcomes during 1-year follow-up. Our study revealed a general decrease in pro-angiogenic factor levels after PTA and their subsequent stabilization during subsequent observation. The results indicated a significant association between plasma circulating FGF-2 level and poor outcomes (including the incidence of restenosis/reocclusion of treated arteries) during 12 months of observation. The perioperative changes in FGF-2 showed a significant association with LDF alterations after PTA. Follow-up 1-3 months post-intervention showed a tendency towards elevated TcpO2, VEGF-A, and VEGF-R2 levels in patients free from adverse events. These results may provide a basis for further research on the potential use of selected circulating angiogenic factors for monitoring the treatment of patients with DFS following PTA.

摘要

外周动脉疾病(PAD)所致缺血是糖尿病足综合征(DFS)的一个重要组成部分。下肢动脉血运重建(包括经皮腔内血管成形术[PTA])的结果并不总是能带来令人满意的长期效果,这是由多种因素导致的。本研究的目的是调查41例DFS患者在接受PTA后选定的循环血管生成因子和微循环参数的变化,并分析它们在1年随访期间与临床结局的关系。我们的研究显示,PTA后促血管生成因子水平普遍下降,随后在后续观察中趋于稳定。结果表明,在12个月的观察期内,血浆循环FGF-2水平与不良结局(包括治疗动脉再狭窄/再闭塞的发生率)之间存在显著关联。PTA后FGF-2的围手术期变化与激光多普勒血流仪(LDF)改变显著相关。干预后1 - 3个月的随访显示,无不良事件的患者中TcpO2、VEGF-A和VEGF-R2水平有升高趋势。这些结果可能为进一步研究选定的循环血管生成因子在监测PTA后DFS患者治疗中的潜在应用提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b153/10488381/db618993d50d/jcm-12-05581-g001.jpg

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