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激光多普勒血流监测、近红外光谱技术及踝肱指数在评估糖尿病足微循环中的应用
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Abstract:
目的：验证激光多普勒血流监测、近红外光谱技术及ABI多种微循环分析方法能否有助于区分血管性糖尿病足和非血管性糖尿病足。方法：回顾性分析2020年08月至2021年07月就诊于安徽医科大学第二附属医院的124例糖尿病足溃疡患者的相关临床资料，根据下肢动脉造影的结果，将这124例糖尿病足患者分为两类：血管性糖尿病足(VDF组)和非血管性糖尿病足(NVDF组)，分别应用激光多普勒血流仪和近红外光谱组织氧饱和度仪、周围血管检查仪测量糖尿病足溃疡周围的血流值、组织氧饱和度值和患肢ABI，对比分析两组患者血流值、组织氧饱和度值和ABI的差异。结果：124例糖尿病足患者，VDF组的血流值(5.7 ± 1.15 PU)、组织氧饱和值(63.31% ± 4.18%)和ABI (0.48 ± 0.12)明显低于NVDF组的血流值(9.62 ± 2.78 PU)、组织氧饱和值(73.46% ± 4.45%)和ABI (0.78 ± 0.51)，差异有统计学意义(p < 0.05)。结论：激光多普勒血流检测、近红外光谱技术及ABI有助于区分血管性糖尿病足和非血管性糖尿病足，可以在临床推广应用，用于不同类型的糖尿病足溃疡的诊断和鉴别。
Objective: To verify whether microcirculation analysis which includes laser Doppler blood flow detection(LDF), near-infrared spectroscopy technology (NIRS) and ABI can help to distinguish vascular diabetic foot (DF) from non-vascular diabetic foot (NVDF). Methods: The clinical data of 124 patients with diabetic foot ulcers which treated in the Second Affiliated Hospital of Medical University of Anhui from August 2020 to July 2021 were retrospectively analyzed. According to the results of lower extremity arteriography, the 124 patients with diabetic foot were divided into two categories: vascular diabetic foot (group VDF) and non-vascular diabetic foot (group NVDF). The values of blood flow, tissue oxygen saturation and ABI of patients with diabetic foot ulcers were measured by laser Doppler flowmetry and near infrared spectroscopy tissue oxygen saturation instrument and peripheral vascular examination instrument. The differences of blood perfusion value, tissue oxygen saturation and ABI between the two groups were compared. Results: In 124 patients with diabetic foot, blood perfusion value (5.79 ± 1.15 PU), tissue oxygen saturation (63.31% ± 4.18%) and ABI (0.48 ± 0.12) in group VDF were significantly lower than those which include blood perfusion value (9.62 ± 2.78 PU), tissue oxygen saturation (73.46% ± 4.45%) and ABI (0.78 ± 0.51) in group NVDF (P < 0.05). Conclusion: Laser Doppler flow, near-infrared spectroscopy technology and ABI are helpful in differentiating vascular diabetic foot from non-vascular diabetic foot, which can be widely applied in clinical diagnosis and differential diagnosis of diabetic foot ulcers (DFU).
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