Abstract
Aim: to assess the blood flow state and the lymphocyte plasma membrane blebbing in atherosclerosis of the lower limb arteries and the ischemic diabetic foot (IDF).Patients and Methods: 75 patients (51 (68%) of them — women) underwent a prospective study with IDF and signs of chronic obliterating disease of lower limb arteries. In the majority of cases (92%), IDF occurred in the setting of type 2 diabetes mellitus. Blood circulation disorder corresponded to the stage II–III Fontaine–Pokrovsky classification, ulcerative defects — to the PEDIS grade 1–2 without signs of infection and with signs of local inflammation. The control group consisted of 25 healthy patients. Blood flow state (using Doppler ultrasound of the lower limb arteries) and diabetes mellitus compensation degree (by the level of glycated hemoglobin), as well as the lymphocyte membrane state were evaluated.Results: 72% of patients had a total occlusion of tibial and foot segments, 28% — stenosis. The level of glycated hemoglobin was 10.3 [8.5; 14.3]%, which indicated insufficient compensation of carbohydrate metabolism disorders. Total and terminal blebbing was 30.1 [25.4; 33.2]% and 15.8 [11.8; 18.4]%, which was 3 and 5 times higher than the control group, respectively. A high positive correlation was observed between the level of glycated hemoglobin and total (rS=0.72; p=0.001) and terminal (rS=0.78; p=0.001) lymphocyte membrane blebbing.Conclusion: given the presence of a high correlation between the indicator of glycated hemoglobin and lymphocyte plasma membrane blebbing, an increase in glycated hemoglobin can be used as a marker for the development of endothelial insufficiency in atherosclerosis of the lower limbs and IDF. At the same time, the level of total and terminal blebbing can be considered as a pathogenetic marker of macroangiopathy. KEYWORDS: diabetes mellitus, atherosclerosis, ischemia, hemodynamics, blebbing, glycated hemoglobin.FOR CITATION: Dunaevskaya S.S., Khachatryan A.T., Deulina V.V. Blebbing of plasma membrane of lymphocytes in patients with atherosclerosis of main arteries and ischemic form of diabetic foot syndrome. Russian Medical Inquiry. 2020;4(7):452–456. DOI: 10.32364/2587-6821-2020-4-7-452-456.
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