| Background:Diabetic foot(DF)is the most serious and the worst prognosis of chronic complications of diabetes mellitus,which is characterized by diffuse vascular damage and foot tissue ulcer.Wagner grade 0-2 is the early stage of diabetic foot and has certain reversibility,so it is particularly important to intervene in the early stage of DF.The development of DF is closely associated with the abnormal lower extremity arteries hemodynamics.The hemodynamic changes of lower limbs affect foot perfusion,which is closely related to the prognosis of DF.In recent years,enhanced external counterpulsation(EECP)has been widely used in the treatment of various ischemic diseases and may improve the hemodynamic characteristics of cardiovascular and cerebrovascular diseases.However,there is no relevant research on the effects of EECP on lower extremity arterial hemodynamics in DF patients.It is of great significance to explore whether EECP can produce beneficial hemodynamic effects on DF.Aims:The study set out with the aim of investigating the effect of EECP on lower limb arterial hemodynamics in Wagner0-2 DF patients.Methods:1.Twenty patients with Wagner grade 0-2 DF in our hospital were selected as DF group,and 15 healthy people matched with age and sex were selected as healthy group.The hemodynamic parameters including arterial internal diameter(D),time-averaged flow velocity(TAmean),peak systolic flow velocity(PSV),pulsatility index(PI),resistance index(RI)and blood flow(VF)were recorded in the lower limb arteries(anterior tibial artery,posterior tibial artery and dorsalis pedis artery)of the two subjects before enrollment in the test and the differences between the two groups were compared.2.Subsequently,20 patients in DF group were randomly divided into DF test group(n=10)and DF control group(n=10),and the baseline data of the two groups were recorded.Both groups of patients continued the previous treatment plan,and the DF test group was treated with EECP once a day for 1 hour each time,5 times a week and a total of 35 sessions.After treatment,the lower extremity arterial hemodynamic parameters of the two groups were measured again,and the differences of each index before and after treatment were compared.Results:1.During the course of this study,2 cases absent in the DF test group and 1 case in the control group.Finally,32 cases were completed,including 15 cases in the normal group,8 cases in the DF test group and 9 cases in the DF control group.There was no significant difference in baseline data between the two groups of DF patients(P>0.05).2.The patients in the DF group had lower arterial D,PSV,VF,PI and RI in both lower limbs than the normal group,and the difference was statistically significant(P<0.05).3.After EECP treatment,the PSV and VF of bilateral lower extremity arteries in DF test group were higher than those before treatment,and PI and RI were lower than those before treatment,with statistically significant differences(P<0.05).However,there were no changes in the D,PSV,VF,PI and RI of lower extremity arteries after treatment in the DF control group(P>0.05).Conclusion:EECP can accelerate the blood flow velocity of lower extremity arteries,reduce arterial resistance and increase the blood flow volume of lower limb artery in DF patients.EECP may be an effective treatment for patients with DF. |
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