Background. The effects of treatment conducted on patients suffering from atherosclerosis and ischemia of lower limbs on red cells: elasticity, erythropoesis, oxygen dissociability from hemoglobin, and antioxidative potential was investigated
Material and methods. Sixty three patients with mean claudication distance of 400 m and AB/I 0.70 undergoing conservative treatment (12 weeks of controlled treadmill training and pentoxifylline administration), and forty four patients with critical leg ischemia mean claudication distance below 50 m or rest pain, AB/I 0.30 who underwent surgical revascularisation (bypass grafts) were included in the present study. The controls consisted of 22 age-matched patients without signs of leg ischemia. Blood samples for evaluation of red cell deformability, concentration of diphosphoglyceric acid (2,3-DPG), reticulocyte count and red cell antioxidant status: concentration of reduced gluthation (GSH), and superoxide dysmutase (SOD) [EC-1.15.1.1] were collected at entry, after 6 weeks and after 12 weeks from initiation of the treatment or after operation. The changes in clinical status were expressed by claudication appearing time (CAT), maximal walking time (MWT) and ankle/brachial index (ABI) values.
Results. In both groups of patients, after 12 weeks there were signs of significant clinical symptomatic improvement expressed as prolongation of CAT and MWT. In the group subjected to conservative treatment, after 12 weeks there was a significant increase of red cell deformability, enhanced erythroneocytosis, oxygen dissociation from haemoglobin (increased 2,3-DPG concentration), and increased red cell antioxidant potential measured by the GSH and SOD concentrations.
Conversely, in the group subjected to successful surgical revascularisation, in spite of significant clinical improvement 12 weeks after operation, both the low red cell deformability and antioxidant potential were not normalized.
Conclusions. In the case of patients with moderate atheromatous leg ischemia subjected to conservative treatment, red cells play an active part in the development of adaptive mechanisms to physical effort. This effect was not observed in the group of patients with critical leg ischemia after revascularisation.