Особенности сердечно-сосудистых нарушений у больных диабетической стопой

Abstract

The purpose — to improve the effectiveness of treatment of diabetic foot patients with cardiovascular disorders. Material and methods. 782 patients with diabetic foot (DF) were under observation. 4 groups were identified: group 1 — VAC therapy was used; group 2 — ultrasonic cavitation; group 3 — modern dressings were used for treatment; group 4 — with a standard treatment. Low doses of statins were used (atorvastatin 10–20 mg/day or rosuvastatin 5–10 mg/day) in 213 patients (27.2%) and 89 patients (11.4%) received moderate or high doses of statins (atorvastatin 40–80 mg/day or rosuvastatin 20 mg/day) in combination with ursodeoxycholic acid (UDCA) preparations (750–1750 mg/day). Results. In the low-dose statin subgroup, the rate of low-density lipoprotein cholesterol levels reduction averaged 17.6 (5.6) % of the initial values; triglycerides, respectively, 12.3 (3.5) % of the initial values; that was statistically significantly lower than in the moderate/high dose statin plus UDCA subgroup of 32.9 (5.4) % and 18.7 (3.2) %, respectively, all p<0.001. In group 1, the average duration of hospital stay and the percentage of postoperative complications were statistically significantly lower in patients who received lipid-lowering therapy (28.5 (3.6) days and 8.8 (2.9) %), compared with those who did not receive this treatment (34.0 (2.8) days and 13.1 (2.6) %); p < 0.001. Similar differences in the length of hospital stay and the percentage of postoperative complications, depending on the lipid-lowering therapy, also occurred in groups 2, 3, and 4 (p < 0.001). Conclusions. The use of lipid-lowering therapy, including moderate / high doses of statins in combination with UDCA, contributed to a decrease in the length of hospital stay and a decrease in the incidence of postoperative complications in all groups of patients with DF.