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足背加速度时间与经皮氧分压的相关性 - 糖尿病足患者伤口愈合的预后工具。

Correlation Between Pedal Acceleration Time and Transcutaneous Oxygen Pressures - A Prognostic Tool for Wound Healing in the Diabetic Foot Population.

机构信息

Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de Santo António, Porto, Portugal.

Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de Santo António, Porto, Portugal.

出版信息

Ann Vasc Surg. 2024 Sep;106:400-407. doi: 10.1016/j.avsg.2024.03.031. Epub 2024 May 29.

Abstract

BACKGROUND

Pedal arch interrogation by ultrasound through systolic acceleration time measurement (Pedal Acceleration Time [PAT]) is a recently described technique that offers valuable insights into foot hemodynamics. Previous studies have demonstrated a correlation between PAT and the ankle-brachial index and PAT has been proposed as a prognostic tool for wound healing in patients with peripheral artery disease. This study aims to assess the correlation between PAT and Transcutaneous Pressure of Oxygen (TcPO2) in the diabetic foot population.

METHODS

In this single-center cross-sectional study PAT and TcPO2 were measured in diabetic patients with ischemic foot ulcers. The assessment of wound status was performed between the 12th and 16th week after the first evaluation. The primary outcome was to assess the correlation between the values obtained for PAT and TcPO2. The secondary outcome was to establish a cut-off value for wound healing.

RESULTS

Sixty limbs with ischemic foot ulcers were evaluated. The results showed a correlation between PAT and TcPO2 [F (1.52) = 16.928; R = 0.246; P < 0.001]. The receiver operating characteristics curve analysis showed an optimal cut-off value at PAT >186 ms for predicting a nonhealing ulcer with a 96% specificity (area under the curve = 0.774; confidence interval 0.648-0.872; P < 0.001).

CONCLUSIONS

PAT showed a significant correlation with TcPO2 with high specificity to identify nonhealing foot ulcers due to insufficient foot perfusion with a potential prognostic value in the diabetic foot population.

摘要

背景

通过收缩期加速度时间测量(Pedal Acceleration Time [PAT])对足弓进行超声检查是一种最近描述的技术,它可以提供有关足部血液动力学的有价值的见解。先前的研究表明,PAT 与踝臂指数之间存在相关性,并且 PAT 已被提出作为预测周围动脉疾病患者伤口愈合的预后工具。本研究旨在评估糖尿病足人群中 PAT 与经皮氧分压(TcPO2)之间的相关性。

方法

在这项单中心横断面研究中,对患有缺血性足部溃疡的糖尿病患者进行 PAT 和 TcPO2 测量。在首次评估后的第 12 周到第 16 周之间进行伤口状况评估。主要结果是评估 PAT 和 TcPO2 之间获得的值之间的相关性。次要结果是确定伤口愈合的截止值。

结果

评估了 60 条有缺血性足部溃疡的肢体。结果显示 PAT 与 TcPO2 之间存在相关性[F (1.52) = 16.928; R = 0.246; P < 0.001]。受试者工作特征曲线分析显示,PAT > 186 ms 时预测未愈合溃疡的最佳截止值,特异性为 96%(曲线下面积 0.774; 置信区间 0.648-0.872; P < 0.001)。

结论

PAT 与 TcPO2 具有显著相关性,具有较高的特异性,可以识别由于足部灌注不足导致的未愈合溃疡,在糖尿病足人群中具有潜在的预后价值。

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