Biochemical and clinico-morphological criteria for the diagnosis of diabetic foot

Abstract

Work is performed on operational material of 94 patients with a diabetic foot syndrome aged from 41 till 76 years. The percent of women -75,5 %, men - 24,5 %. Patients came to separation in 1-3 months from the moment of an onset of the illness, at the time of receipt the diabetes mellitus was compensated at 11% of patients, subcompensated at 23 % and decompensated at 66 %. Three forms of a diabetic foot syndrome are allocated: neuropathic form (76 %), neuroischemic form (18 %), ischemic form (6 %). The preferred arrangement of trophic ulcers on a plantar surface of foot, development of a colliquative necrosis, accession of hypostasis and vascular disorders, the expressed perifocal infiltration by polymorphonuclear leukocytes is characteristic of a neuropathic form. Sugar level in blood averaged 8,88 mmol/l. For ischemic form of diabetic foot syndrome (DFS) is characterized by the location of the ulcers over the entire surface of the foot, the presence of coagulative necrosis, edema. The inflammatory infiltration is less expressed. Vascular disorders are characteristic: accumulation of glycoproteids in a vessel wall, plasmatic imbuing, thickening of a basal membrane, proliferation of an endothelium. Glucose level in blood made 14,43 mmol/l. Existence of touch neuropathy, macro - and mikroangiopatiya of vessels of the lower extremities, extensive ulcer and necrotic defeats of foot is characteristic of the DFS neuroischemic form. Glucose level in blood made 5,97 mmol/l. As monitoring biochemical indexes of blood of healthy people used.