Jaffer U, Aslam M, Standfield N
Department of Vascular Surgery, Imperial College School of Medicine, Hammersmith Hospital, London, UK.
Eur J Vasc Endovasc Surg. 2008 May;35(5):603-6. doi: 10.1016/j.ejvs.2007.12.006. Epub 2008 Jan 15.
The smooth muscle of distal vascular networks exhibits periodical contraction and relaxation known as rhythmical vasomotion. The nature of microvascular vasomotion has been shown to correlate with severity of peripheral vascular disease. We present basal and post-ischaemic hyperaemic laser doppler flowmetry vasomotion in control and type 1 adult diabetic patients.
Prospective case control study.
Laser Doppler flowmetry was used to measure vasomotion and hyperaemic responses in age and body mass index matched male subjects (25 type 1 Diabetes Mellitus and 13 controls), all with ankle/brachial pressure index (ABPI) >1.0 but <1.2.
The frequency of resting vasomotion was raised in diabetics compared to controls 8 (5-9)min(-1) vs. 5 (4-6)min(-1) (median (range); p<0.0001). The post ischaemic hyperaemia response was significantly higher in the diabetic group compared to the controls 11 (7-12)min(-1) vs. 6 (5-7)min(-1) (median (range); p<0.05). Post ischaemic hyperaemic flux (expressed as percent increase from resting) was significantly lower in the diabetic group compared to controls (234+/-62 vs. 453+/-155%, p<0.01). The time to achieve peak post ischaemic response was also significantly increased in the diabetic group compared to control: 21.4+/-0.4 vs. 12.8+/-5.4sec (mean+/-SD, p<0.05).
Vasomotion frequency and its change during hyperaemic insult is significantly different in Type 1 Diabetes Mellitus subjects compared to controls. The results are similar to patients with macrovascular atherosclerosis. Long term studies of these groups of patients will be required to determine the significance of these findings and whether these changes could be used as a non invasive screening test to predict peripheral early vascular disease in type 1 diabetic patients.
远端血管网络的平滑肌呈现出周期性收缩和舒张，即节律性血管运动。微血管血管运动的性质已被证明与外周血管疾病的严重程度相关。我们展示了对照组和1型成年糖尿病患者的基础和缺血后充血期激光多普勒血流仪测量的血管运动情况。
前瞻性病例对照研究。
使用激光多普勒血流仪测量年龄和体重指数匹配的男性受试者（25例1型糖尿病患者和13例对照组）的血管运动和充血反应，所有受试者的踝/臂压力指数（ABPI）均>1.0但<1.2。
与对照组相比，糖尿病患者静息血管运动频率升高，分别为8（5 - 9）次/分钟 对 5（4 - 6）次/分钟（中位数（范围）；p<0.0001）。糖尿病组缺血后充血反应明显高于对照组，分别为11（7 - 12）次/分钟 对 6（5 - 7）次/分钟（中位数（范围）；p<0.05）。糖尿病组缺血后充血通量（以静息时增加的百分比表示）明显低于对照组（234±62对453±155%，p<0.01）。与对照组相比，糖尿病组达到缺血后反应峰值的时间也显著增加：21.4±0.4对12.8±5.4秒（平均值±标准差，p<0.05）。
与对照组相比，1型糖尿病患者的血管运动频率及其在充血损伤期间的变化显著不同。结果与大血管动脉粥样硬化患者相似。需要对这些患者组进行长期研究，以确定这些发现的意义，以及这些变化是否可以用作预测1型糖尿病患者外周早期血管疾病的非侵入性筛查试验。
