Features of nonlinear dynamic processes of blood microcirculation in patients with obliterating atherosclerosis of lower limbs and diabetes mellitus 2 types

Aim. To study the nature of shifts in the nonlinear dynamics parameters of blood microcirculation (BMC) in patients with obliterating atherosclerosis of the arteries of the lower limbs (OAALL) and concomitant diabetes mellitus (DM).

Materials and Methods. Sixty male patients with OAALL, median age 63.0 [59.0; 68.0] years, who were divided into 2 groups equal in age and basic clinical and anamnestic data, were studied: 1 – patients without DM (n=45) and 2 – with concomitant DM (n=15). Nonlinear dynamic processes of BMC of the foot skin of the affected limb were assessed by laser Doppler flowmetry. The study included determination of fractal dimension (Do, R/S), entropy (Ho, Hi) and phase portrait analysis (D₂, D_2H).

Results. The analysis of nonlinear-dynamic processes of BMC has shown a statistically significant decrease of median values of fractal dimension parameters (Do, R/S) by 30 % and entropy indices (Hi) by 33 % in OAALL patients with concomitant DM in comparison with the group of patients without DM. This indicates a decrease in the number of factors involved in the coordination of microvascular system activity, growth of its functional rigidity, limitation of situational lability and reduction of chaotic behavior.

Conclusion. The study of nonlinear dynamics parameters provides additional data of important clinical significance for the assessment of pathophysiology of the disease. The results obtained indicate a reduction in the reserve of adaptive regulation of BMC in the combination of OAALL with DM and are associated with a worse prognosis of the disease.

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