Effects of hyperbaric oxygen on vascular restenosis in patients with diabetic foot after intervention al therapy

Objective To investigate the effects of hyperbaric oxygen (HBO) on blood biochemical parameters and related factors in patients with diabetic foot (DF) after percutaneous intervention. Methods A retrospective analysis was made on 194 DF patients who sought medical care in Yantaishan Hospital from December 2014 to December 2017. In accordance with different treatment methods, the patients were divided into the control group (n=84) and the observation group (n=110). The patients in the control group received intervention therapy on the basis of routine treatment, while the patients in the observation group were treated with HBO therapy in addition to the treatment received by the control group. Six months after treatment, the incidence of restenosis in the lower extremities was compared between the DF patients of the 2 groups. Anti-superoxide anion radical (Anti-O2-), superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide synthase (TNOS) activity were determined by colorimetry. Serum levels of vascular endothelial growth factor (VEGF) and its receptor Flt-1 were detected by ELISA, and hemorheological factors and blood biochemical indexes were determined by enzyme method and immunoturbidimetry. Results The incidence of arterial restenosis in the observation group (10.9%) was significantly lower than that in the control group (33.3%) 6 months after treatment, and statistical significance could be seen when comparisons were made between them (P<0.01). Six months after surgery, the levels of such indicators as TG, TC, LDL-C, FBG, PBG2 and Hs-CRP in the patients of the observation group all decreased significantly as compared with those before treatment and those of the patients of the control group after surgery, and statistical significance could be noted when comparisons were made between them (P<0.05 or P<0.01). Compared with those the control group, whole blood high shear viscosity, low shear viscosity, plasma viscosity, erythrocyte deformability index, erythrocyte rigidity index and erythrocyte aggregation index were all significantly improved, with statistical significance(P<0.05). The serum levels of Anti-O2- and SOD were all significantly higher than those before surgery and those of the control group after surgery, and the serum levels of MDA and TNOS were all significantly lower than those before surgery and those of the control group after surgery, also with statistical significance(P<0.05). The levels of VEGF and its receptor Flt-1 were significantly lower than those before surgery and those of the control group after surgery, also with statistical significance(P<0.05). Conclusion HBO could significantly reduce the incidence of vascular restenosis in the patients with DF after intervention therapy, the mechanism of which might be associated with the regulation of the levels of plasma hemorheological factor, blood biochemical index, oxidative stress index, VEGF and its receptor Flt-1 in the patients with DF following intervention therapy. Key words: Hyperbaric oxygen; Diabetic foot; Intervention therapy; Vascular restenosis