Study Of Ⅱ Type Diabetic Foot Microcirculation Based On DSA

Objective: DSA,laser Doppler blood flow test,near infrared spectroscopy oxygen saturation test,ankle brachial index and toe brachial index were used to evaluate the microcirculation of type II diabetic foot,and to identify vascular and non-vascular type II diabetic foot.Methods: A retrospective study of patients with type II diabetic foot who were suspected of having vascular causes in the Second Affiliated Hospital of Medical University Of Anhui from 08 months to 07 months in 2020 from the Second Affiliated Hospital of the Medical University Of Anhui was conducted.Color Doppler ultrasound and other imaging examinations showed that 124 patients with diabetic foot were included in the screening cases according to inclusion and exclusion criteria.The relevant clinical data of the included cases were collected and analyzed.Then the blood flow values,tissue oxygen saturation values and ABI and TBI of the affected limbs were measured by laser Doppler flowmeter and near infrared spectroscopy tissue oxygen saturation instrument and peripheral vascular examination apparatus.The DSA of the affected limbs was checked according to the results of DSA examination.The patients were divided into two groups: vascular diabetic foot（DSA suggesting moderate or severe stenosis or occlusion of lower extremity artery）and non-vascular diabetic foot（no artery stenosis or mild stenosis of the lower extremities）.All patients were followed up for 6 months.All data were collected by SPSS 26.0 statistical analysis.P < 0.05 was statistically significant.Results: 1)A total of 124 cases of type II diabetic foot（59 cases）（45.2%）,including 41 males,18 females,mean age 70.49 + 12.50 years old,and 65 cases of non-vascular diabetic foot（54.8%,male 44,female 54.8%,average age,54.8% years）.2)The basic clinical data of two groups of patients: a total of 124 patients were collected.The clinical data of two groups,such as gender,age,fasting blood glucose level,glycosylated hemoglobin,duration of diabetes,Wagner classification,ulcer site,BMI,smoking history,hemoglobin,white blood cell count,triglyceride,blood cholesterol,bacterial culture,etc.There was no significant difference in diabetes complications（p>0.05）.There was a significant difference in the location of ulcer between the two groups（p<0.05）.The location of vascular diabetic foot ulcers was mainly in the toes（accounting for 57.63%）,and the non-vascular diabetic foot ulcers were mainly in the sole（44.62%）and the heel（36.92%）.3)Comparison of microcirculation evaluation between the two groups: the blood flow value measured by laser Doppler flowmeter in the experimental group（5.79 ± 1.147pu）was significantly lower than that in the control group（9.62 ± 2.78pu）,P < 0.05;The oxygen saturation of the experimental group（63.31 ± 4.18%）was significantly lower than that of the control group（73.46 ± 4.45%）,P < 0.05;Abi（0.48 ± 0.12）and TBI（0.26 ± 0.70）in the experimental group were significantly lower than those in the control group（0.78 ± 0.51）and TBI（0.58 ± 0.47）,P < 0.05.4)Correlation analysis between ABI and BPV,r SO2,TBI: BPV,r SO2,ABI and TBI are correlated with each other,with significant correlation.The correlation coefficient is positive and positive correlation.5)Comparison of follow-up between the two groups: 40 cases of ulcer healing,16 cases of amputation（toe）and 3 cases of death in VDF group;There were 55 cases of ulcer healing,9 cases of amputation（toe）and 1 case of death in NVDF group（P < 0.05）.Conclusion: 1)Using DSA,laser Doppler blood flow detection,tissue saturation detection by near infrared spectroscopy,ABI and TBI for microcirculation assessment are effective methods to identify vascular diabetic foot.2)Clinically,laser Doppler blood flow test,near infrared spectroscopy,tissue oxygen saturation test,ABI and TBI can be used for non-invasive microcirculation assessment,screening for patients with vascular diabetic foot,and then diagnosed by DSA and treated simultaneously.3)Vascular diabetes foot has lower ulcer healing rate,higher amputation rate and higher mortality rate than non-vascular diabetic foot,and the prognosis is poor.