In this prospective observational pilot study, we enrolled 35 T2DM subjects who underwent lower limb PTA. Transcutaneous oximetry was performed in all patients before and 6 weeks after PTA. The change in oxygen partial pressure (TcpO2) before and after PTA was expressed as TcpO2-delta (ΔTcpO2). VWF antigen, VWF activity and ADAMTS-13 activity were measured before and 6 weeks after PTA; changes were expressed as delta and ratio from baseline.
Subjects with ∆TcpO2 < 15 mmHg presented higher ΔVWF activity (p = 0.050) and lower ADAMTS-13 activity ratio (p = 0.080). Subjects with ∆TcpO2 < 30 mmHg showed lower ADAMTS-13 activity Δ and ratio (p = 0.028).
VWF antigen levels and VWF activity may potentially affect PTA outcome. Higher levels of VWF could derive from VWF release as consequence of PTA-induced mechanical endothelial damage and/or oxidative stress-induced modifications of VWF structure with impairment of VWF-ADAMTS13 interactions.
方法:在这项前瞻性观察性试点研究中,我们招募了35名接受下肢PTA的T2DM受试者。在PTA之前和之后6周,对所有患者进行了经皮血氧测定。PTA前后氧分压(TcpO2)的变化表示为TcpO2-δ(ΔTcpO2)。VWF抗原,在PTA之前和之后6周测量VWF活性和ADAMTS-13活性;变化表示为与基线的增量和比率。
结果:ΔTcpO2<15mmHg的受试者表现出较高的ΔVWF活性(p=0.050)和较低的ADAMTS-13活性比(p=0.080)。ΔTcpO2<30mmHg的受试者显示较低的ADAMTS-13活性Δ和比率(p=0.028)。
结论:VWF抗原水平和VWF活性可能潜在地影响PTA结果。由于PTA诱导的机械内皮损伤和/或氧化应激诱导的VWF结构修饰以及VWF-ADAMTS13相互作用的损害,VWF的较高水平可能来自VWF释放。