[Intra-arterial thrombolytic therapy of ischaemic complications of lower-limb diabetic angiopathy].
Based on the parameters of haemostasis, free radical oxidation and endogenous intoxication the study was aimed at assessing efficacy of intra-arterial administration of urokinase medac in complicated forms of lower-limb diabetic angiopathy. The authors assessed the outcomes of treating a total of 32 patients with complicated forms of lower-limb diabetic angiopathy on the background of basic therapy and 30 patients whose combined therapy included intra-arterial administration of the thrombolytic agent urokinase medac, also studying the indices of haemostasis, endogenous intoxication, free-radical oxidation and antioxidant defence. At admission to hospital, patients were found to have shifts of the coagulogram towards hypercoagulation. The group of patients receiving intra-arterial administration of urokinase showed that the examined parameters on day 20 of treatment as compared with basic therapy alone increased: those of coagulability by 6% (p<0.05), activated partial thromboplastin time by 14% (p<0.01), thrombin time by 9.2% (p<0.01), antithrombin III by 7% (p<0.001). The fibrinogen level decreased by 9% (p<0.05), malonic dialdehyde concentration dropped by 30% (p<0.001), the concentrations of catalase and superoxide dismutase elevated by 55% (p<0.001) and 42%, respectively (p<0.05). The effective concentration of albumin by day 20 increased up to 42.03±0.36 g/L and was by 5% higher as compared with the basic therapy alone (p<0.005). The toxicity index fell to 0.04+0.1 which was by 50% less than after basic therapy. Conclusion. Intra-arterial administration of urokinase medac in treatment of lower-limb diabetic angiopathy considerably normalizes elevated processes of coagulation, accompanied by decreased intensity of free-radical oxidation and followed by elevated concentration of the antioxidant protection enzymes and a decrease in the degree of endogenous intoxication.
A N
AN
Beliaev
A G
AG
Pavelkin
A N
AN
Rodin
D003925:Diabetic Angiopathies / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005263:Femoral Artery; D005500:Follow-Up Studies; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D007269:Injections, Intra-Arterial; D007511:Ischemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D035002:Lower Extremity / Q000098:blood supply*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D014568:Urokinase-Type Plasminogen Activator