Assessment of Leg Ulcer Microcirculation

腿部溃疡微循环的评估

基本信息

批准号：
8743790
负责人：
Alexander Gorbach
金额：
$ 2.83万
依托单位：
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/8743790
关键词：
Adult Age Anastomosis - action Anemia Area Beds Biopsy Blood Vessels Blood flow Characteristics Chronic Clinical Complication Cutaneous Development Disease Endothelium Evaluation Eye Frequencies Functional disorder General Population Healed Hemolysis Human Image Impaired wound healing Inflammation Laboratories Lasers Leg Ulcer Manuals Measurement Methodology Microcirculation Microscopic Monitor Organ Patients Photography Population Sickle Cell Anemia Skin Skin Ulcer Sterile coverings Surface Techniques Therapeutic Therapeutic Agents Thermography Thrombophilia Thrombosis Ulcer Varicose Ulcer Vascular Diseases Vascular blood supply Vasodilation Venous Visible Radiation healing

Adult Age Anastomosis - action Anemia Area Beds Biopsy Blood Vessels Blood flow Characteristics Chronic Clinical Complication Cutaneous Development Disease Endothelium Evaluation Eye Frequencies Functional disorder General Population Healed Hemolysis Human Image Impaired wound healing Inflammation Laboratories Lasers Leg Ulcer Manuals Measurement Methodology Microcirculation Microscopic Monitor Organ Patients Photography Population Sickle Cell Anemia Skin Skin Ulcer Sterile coverings Surface Techniques Therapeutic Therapeutic Agents Thermography Thrombophilia Thrombosis Ulcer Varicose Ulcer Vascular Diseases Vascular blood supply Vasodilation Venous Visible Radiation healing

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项目摘要

Chronic leg ulcers are frequent and debilitating complications of sickle cell anemia. Inadequate blood supply has been postulated to be an important factor in their occurrence and delayed healing. Little is known about their microcirculatory and histopathological changes. We evaluated the microcirculation of lower extremity ulcers with laser speckle contrast imaging and infrared thermography, and obtained clinical and laboratory characteristics in 18 adults with sickle cell anemia and chronic leg ulcers. Skin biopsies were obtained in four subjects. Subjects had markers of severe disease, anemia, and high degree of hemolysis, inflammation and thrombophilia. Higher blood flow was present in the ulcer bed, lesser in the immediate periwound area, compared to an unaffected control skin area. Microscopic examination showed evidence of venostasis, inflammation, and vasculopathy. Blood vessels were increased in number, had activated endothelium and evidence of thrombosis/recanalization. High blood flow may be due to chronic inflammation, cutaneous vasodilatation, and involvement of arterio-venous anastomosis. These changes in skin microcirculation are similar to chronic venous ulcers in the non-SCD population, thus suggesting that leg ulcers may be another end-organ complication with endothelial dysfunction that appears in patients with SCD at a younger age and with higher frequency than in the general population.

慢性腿部溃疡经常发生，使镰状细胞贫血的并发症令人衰弱。据推测，血液供应不足是其发生和延迟愈合的重要因素。关于它们的微循环和组织病理学变化知之甚少。我们通过激光斑点对比度成像和红外热成像评估了下肢溃疡的微循环，并在18名患有镰状细胞贫血和慢性腿部溃疡的成年人中获得了临床和实验室特征。在四个受试者中获得了皮肤活检。受试者具有严重疾病，贫血和高度溶血，炎症和血栓形成的标志。与未受影响的对照皮肤区域相比，溃疡床中存在更高的血流，在附近围绕着附近区域的血流较小。显微镜检查显示静脉炎，炎症和血管病的证据。血管数量增加，活化的内皮和血栓形成/再通的证据。高血流量可能是由于慢性炎症，皮肤血管舒张以及动脉 - 病吻合的参与。皮肤微循环的这些变化与非SCD种群中的慢性静脉溃疡相似，因此表明腿部溃疡可能是另一种最终器官并发症，内皮功能障碍在SCD年龄较小且频率更高的患者中出现的内皮功能障碍。