Journal «Angiology and Vascular Surgery» • 

2009 • VOLUME 15 • №4

Lactate as a marker of ischaemia in patients with atherosclerosis obliterans of the lower limb arteries on the background of dosed physical load

Sergeeva N.A., Sinyakin K.I., Koshkina I.V.

Laboratory on Problems of Angiology, Rheumatology ar d Anaesthesiology Russian State Medical University, Moscow, Russia

The work was aimed at determining the concentration of lactate as a marker of ischaemia in patients with lower-limb atherosclerosis obliterans (hereinafter referred to as LLASO) on the background of dosed physical load (terrain cure and general physical exercises). We examined a total of 157 patients subdivided into 4 groups, i.e., 2 study groups and 2 control groups. All the patients were found to have grade 2a-2b ischaemia. The first study group consisted of the patients who had previously been receiving standard conservative therapy for several years. They were recommended to continue this type of therapy to be only supplemented with dosed physical loading. The 1st control group enrolled a total of 20 patients commissioned to receive conventional therapy alone. Patients from the 2nd study group had received no previous therapy. They were offered monotherapy in the form of dosed physical loads. Patients of the 2nd control group, also previously untreated, were given standard conservative therapy combined with physical loads. All the patients examined were initially found to have had high values of the blood lactate level. We then determined the possibility of walking and the dynamics of the blood lactate level on the background of the therapy offered, thus allowing us to confirm high efficacy of terrain cure eventually leading to increased distance of pain-free walk, both as a constituent part of the combined modality therapy and in the form of monotherapy in patients presenting with LLASO. We also revealed a correlation between the blood lactate level and the increase in the distance walked. The obtained findings suggest that the blood lactate level may be a marker of the presence of ischaemia in LLASO patients and the degree of its severity.

KEY WORDS: lactate, atherosclerosis obliterans ischaemia, terrain cure.

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