АНАЛИЗ ВЛИЯНИЯ РЕВАСКУЛЯРИЗАЦИИ НА ПУЛ АМИНОКИСЛОТ И ОПРЕДЕЛЕНИЕ ЕГО РОЛИ В РАЗВИТИИ ПОСЛЕОПЕРАЦИОННЫХ ОСЛОЖНЕНИЙ У ПАЦИЕНТОВ С ЗАБОЛЕВАНИЯМИ АРТЕРИЙ НИЖНИХ КОНЕЧНОСТЕЙ

Abstract

Progressive course of lower extremity arterial disease (LEAD) leads to intermittent claudication, critical ischemia and gangrene for which amputations are performed. Revascularizing surgeries help avoid limb loss, but the results are not satisfactory. Amino acids have different effects on the development and course of atherosclerosis, so some of them can be considered as predictors of postoperative complications in patients with LEAD. Objective: to analyze the effect of revascularization surgeries on amino acid pool indexes among patients with LEAD and to determine their correlation with the rate of postoperative complications. Materials and methods: 133 patients with LEAD were examined. The age of the examined patients was 63 [57; 68] years. All the patients suffered from chronic arterial insufficiency. The levels of amino acids and their derivatives were determined by high-performance liquid chromatography. Results and discussion: After revascularization there were statistically significant changes in the values of the following amino acids: Hsu, gGluCys, Asn, Gln, His, 1MHis, HpTau, Tau, Tyr, aABA, Val, Met, Trp, Ile, Leu, Lys, Pro. The patient follow-up period was 20 [12; 26] months. During this observation period, 31 complications were revealed. We identified the most significant amino acids influencing the development of postoperative complications: Hcy, CysGly, PSer, 3MHis, 1MHis and HPro. Hcy, CysGly, and 1MHis appeared to be the most powerful predictors. Using these predictors, a prognostic model was developed with a sensitivity of 74.19%, specificity of 74.51%, and accuracy of 74.44%. Conclusions: Successfully performed revascularization, by eliminating ischemia, is able to affect amino acid pool values. Hsu, CysGly and 1MHis are the most reliable predictors of postvascularization complications among the patients with LEAD.