Динамика маркеров ангиогенеза у пациентов с облитерирующим атеросклерозом после оперативного лечения

Abstract

INTRODUCTION: The processes of regulation of blood circulation in any organism are in constant dynamic interaction due to the systems of pro- and anti-angiogenesis. The main proangiogenic factors include HIF1a, VEGF, PDGF. Depending on the concentration of these factors in the blood serum, it is possible to make an assumption about the activity of the angiogenesis system in the patient and assess the degree of its activity. AIM: To evaluate the activity of neoangiogenesis in the postoperative period in patients with obliterating atherosclerosis of the arteries of the lower extremities. MATERIALS AND METHODS: The study included data from 40 patients with obliterating atherosclerosis, who had a clinic picture of critical ischemia of the lower extremities, who underwent direct open revascularization operations. The content of HIF1a, VEGF and PDGF was evaluated in the pre- and early postoperative periods, and further during 1 year of monitoring. RESULTS: The HIF1a index from the initial 0.52 ng/ml in the early postoperative period decreased to 0.381 ng/ml (decrease by 27%, p = 0.004), in 1 month and 6 months of monitoring its concentration practically did not change (0.41 ng/ml in 1 month (p = 0.004), 0.398 ng/ml by 6 months (p = 0.003)), and the tendency to recovery was outlined only by 1 year of monitoring (0.495 ng/ml). The concentration of VEGF was initially 728 pg/ml, the decrease in its concentration was observed more smoothly and reached a minimum by 1 month of monitoring (552.2 pg/ml for 5–7 days and 480.7 pg/ml by 1 month (p = 0.025)). Further, during the monitoring, the concentration of VEGF increased by 6 months (529.8 pg/ml) and by 1 year of monitoring (515 pg/ml). Initially PDGF was 3563.8 pg/ml, and the most marked decrease in its concentration to 2922.5 pg/ml was observed already on the 5th–7th days after surgery (p = 0.043). Then the concentration of PDGF increased by 1 month of monitoring (3254.3 pg/ml) and remained at the same level (3270 pg/ml by 1 year), still not reaching the initial preoperative values. CONCLUSION: The maximum decrease in the concentration of proangiogenic factors was detected in the early postoperative period, which indicates a low activity of angiogenesis in this time interval and is the optimal time target point for the use of therapeutic angiogenesis techniques.