2型糖尿病患者慢性四肢威胁性缺血:重血管化指数作为主要内血管干预结果预测指标
Nawaf J Shatnawi1, Nabil A Al-Zoubi1, Lujain A Al-Bakkar1
1Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan.
Vascular health and risk management
|August 7, 2023
概括
一个新的再血管化指数 (RI) 有效地预测了2型糖尿病和经历内血管干预的慢性肢体威胁性缺血患者的结果. 较低的RI分数表明较大的截肢风险更高,需要进行二次再血管化.
科学领域:
- 血管外科 血管外科
- 糖尿病学 糖尿病学
- 干预性放射学 干预性放射学
背景情况:
- 糖尿病患者的慢性四肢威胁性缺血症 (CLTI) 具有很高的不良结果风险.
- 糖尿病CLTI管理的复杂性包括并发症,足部表现的多样化和扩散性动脉样硬化病变.
- 现有的评分系统和再血管化策略旨在优化结果.
研究的目的:
- 引入一个新的再血管化指数 (RI).
- 评估RI在CLTI2型糖尿病患者的初级内血管干预后结果的预测能力.
主要方法:
- 对187名2型糖尿病和CLTI患者的电子病历进行了回顾性审查.
- 患者在2014年1月至2019年8月期间接受了初级内血管干预.
- 对二次再血管化,重大截肢和死亡率的RI预测价值的分析.
主要成果:
- 该研究包括187名患者,其主要下肢截肢率为19.3%.
- 该RI显示了对二次重血管化的良好预测 (AUC=0.80) 和对主要截肢的良好预测 (AUC=0.76).
- 一个RI<1.21显著与较大的下肢截肢风险增加相关 (HR=5.8),和RI<1.3预测了较高的二次再血管化需求.
结论:
- 重血管化指数 (RI) 可以预测糖尿病CLTI患者下肢主要不良事件 (MALE).
- RI可以作为一个有价值的工具来指导内血管干预的范围.
- 这一指数特别适用于管理多层次输出动脉样硬化疾病的糖尿病CLTI.
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