ABSTRACT
Objective The incidence of chronic lower limb ischemia caused by arteriosclerotic obliteration of lower extremities is increasing recent years and there is a high risk of amputation and mortality.This study was to find out the changes in a single center for 16 years.Methods A retrospective analysis of the data of patients in single-center vascular surgery in the past 16 years was carried out.The patients with chronic lower limb ischemia caused by lower limb arteriosclerosis obliterans were screened out,and the data of operation information,amputation,length of stay and hospitalization expenses during hospitalization were collected.Results A total of 4 602 patients were included,of whom 57.39％ were diabetic.It was found that the number of patients admitted,the number of endovascular treatment,the average cost of hospitalization increased year by year,and the average length of hospitalization decreased year by year.The amputation rate decreased from 8.12％ (from 2002 to 2007) to 0.92％ (from 2008 to 2017) (P ＜ 0.01).The average days of hospitalization decreased from 28.20 days (from 2002 to 2007) to 11.65 days (from 2008 to 2017) (P ＜ 0.01).The average hospitalization cost rose from 54 466.94 yuan (from 2002 to 2007) to 73 685.22 yuan (from 2008-2017) (P ＜ 0.01).There was no significant difference in amputation rate,hospitalization days and hospitalization costs between diabetic group and non-diabetic group.In diabetic subgroup,amputation rate decreased from 8.83％ (between 2002 and 2007) to 1.05％ (between 2008 and 2017) (P ＜ 0.01).The average hospitalization days decreased from 30.12 days (between 2002 and 2007) to 12.60 days (between 2008 and 2017) (P ＜ 0.01).The average cost of hospitalization rose from 58 530.94 yuan (between 2002 and 2007) to 74 433.75 yuan (between 2008 and 2017) (P ＜ 0.01).Conclusions From 2002 to 2017,the number of patients with chronic lower limb ischemia increased gradually,and so as the number of endovascular treatment.While the amputation rate and average hospitalization time decreased,and the average hospitalization cost increased.The same trend was observed in the diabetic subgroup.The significant decrease in amputation rate may be related to the development of endovascular therapy and angiogenesis therapy.
ABSTRACT
Objective To explore the association between serum vaspin levels and the severity of the lower extremity vascular lesions in type 2 diabetes mellitus (T2DM) patients.Methods According to the lower extremity artery plaque,stenosis and intima-media membrane thickening severity score,92 cases of T2DM patients were divided into three groups:simple diabetes group (DM1 group) (32 cases),mild diabetic lower limb vascular lesion group (DM2 group) (33 cases),and moderately severe diabetic lower limb vascular lesion group (DM3 group) (27 cases).Twenty-six age-and gender-matched apparently healthy controls (control group) were recruited as well.Systolic blood pressure (SBP),ankle-brachial index (ABI),insulin resistance index (HOMA-IR),and other indicators were determined,serum vaspin was measured by enzyme-linked immunosorbent assay.Results After adjustment for age and gender,the DM1 group had a significantly higher serum vaspin level than control group (P ＜0.01),while for the DM2 and DM3 groups,serum vaspin levels were significantly lower than the DM1 group (P ＜ 0.01).Partial correlation analysis showed that serum vaspin was inversely associated with HOMA-IR (r =-0.461,P =0.001)and positively correlated with ABI (r =0.462,P =0.001).Logistic regression analysis demonstrated that SBP,ABI and fasting serum vaspin levels were significantly associated with the presence of the lower extremity vascular lesions in type 2 diabetes.Conclusions Serum vaspin levels were significantly elevated in simple type 2 diabetic patients while the reduction of its level might be associated with the formation of lower extremity vascular lesions in type 2 diabetic patients.