DeFeo W T, Jay R M
J Foot Surg. 1976 Winter;15(4):159-65.
Diabetes mellitus and arteriosclerotic vascular disease have been found to be the predisposing factors of osteomyelitis associated with peripheral vascular disease (10). A diabetic person is more susceptible to osteomyelitis because of the microangiopathy, peripheral neuropathy and decreased resistance to infection. In diabetes mellitus there can be microangiopathy which results from the proliferation of the endothelium of the intima and thickening of the basement membrane. This further contributes to a sluggish blood flow. In the patient with arteriosclerotic vascular disease, the lumens of the arterioles and arterioles are compromised by the atheromatous plaques. The anatomic structure of the blood supply to bone along with the pathologic membrane thickening, allows for slowing of blood. This slowing of blood flow causes micro-thrombi and enhances bacterial growth. In diabetes mellitus it has been shown that there is a decreased immunologic response which, along with the above, contributes to the sheltering and proliferation of bacteria in the small bones of the foot.
糖尿病和动脉硬化性血管疾病已被发现是与周围血管疾病相关的骨髓炎的诱发因素（10）。糖尿病患者由于微血管病变、周围神经病变和抗感染能力下降，更容易患骨髓炎。在糖尿病中，可能存在微血管病变，这是由内膜内皮细胞增殖和基底膜增厚引起的。这进一步导致血流缓慢。在患有动脉硬化性血管疾病的患者中，小动脉和微动脉的管腔会被动脉粥样硬化斑块阻塞。骨骼血液供应的解剖结构以及病理性膜增厚会导致血流减慢。这种血流减慢会导致微血栓形成并促进细菌生长。在糖尿病中，已经表明免疫反应会降低，这与上述情况一起，有助于细菌在足部小骨骼中隐匿和繁殖。
