Urbancic-Rovan Vilma, Bernjak Alan, Stefanovska Aneta, Azman-Juvan Katja, Kocijancic Andreja
University Medical Centre, Department of Endocrinology, Diabetes and Metabolic Diseases, Zaloska 7, 1525 Ljubljana, Slovenia.
Diabetes Res Clin Pract. 2006 Aug;73(2):166-73. doi: 10.1016/j.diabres.2006.01.002. Epub 2006 Jan 31.
Impaired blood supply is a significant risk factor for diabetic foot ulceration and gangrene. A possible relationship between peripheral macroangiopathy and the spectral components of microvascular skin blood flow in the lower extremities was tested in diabetic patients (DP) and non-diabetic subjects (C).
Basal skin blood flow (BSBF) was recorded for 30min at the right and left medial malleolus (predominantly nutritive capillary circulation) by laser Doppler flowmetry in 64 DP and 31 C. Its oscillatory components were analyzed using wavelet transform. Peripheral arterial obliterative disease (PAOD) was defined according to ankle/brachial index (ABI): PAOD+ (ABI<0.9: 21 DP, 12 C), PAOD- (ABI 0.91-1.3: 43 DP, 19 C).
No statistically significant differences in BSBF and its oscillatory components were observed between PAOD+ and PAOD-, neither in DP nor in C. In DP, the spectral component of microvascular flow associated with endothelial activity was in significant positive correlation with systolic pressures on brachial and dorsal pedal artery (p=0.001 and 0.010, respectively).
These results indicate that mean BSBF and its oscillatory components do not change with diabetic PAOD; however there is a strong correlation between systolic pressure and the oscillatory components of BSBF related to endothelial activity manifested in the frequency interval 0.0095-0.02Hz.
血液供应受损是糖尿病足溃疡和坏疽的一个重要危险因素。在糖尿病患者（DP）和非糖尿病受试者（C）中，测试了外周大血管病变与下肢微血管皮肤血流频谱成分之间的可能关系。
通过激光多普勒血流仪在64例DP患者和31例C受试者的左右内踝（主要是营养性毛细血管循环）记录基础皮肤血流（BSBF）30分钟。使用小波变换分析其振荡成分。根据踝臂指数（ABI）定义外周动脉闭塞性疾病（PAOD）：PAOD +（ABI <0.9：21例DP，12例C），PAOD -（ABI 0.91 - 1.3：43例DP，19例C）。
在DP组和C组中，PAOD +和PAOD -之间在BSBF及其振荡成分方面均未观察到统计学上的显著差异。在DP组中，与内皮活性相关的微血管血流频谱成分与肱动脉和足背动脉的收缩压呈显著正相关（分别为p = 0.001和0.010）。
这些结果表明，平均BSBF及其振荡成分不会随糖尿病性PAOD而改变；然而，收缩压与BSBF的振荡成分之间存在强相关性，该振荡成分与内皮活性相关，表现为频率区间在0.0095 - 0.02Hz。
