Shore A C, Price K J, Sandeman D D, Green E M, Tripp J H, Tooke J E
Diabetes Research Laboratories, Postgraduate Medical School, University of Exeter, UK.
Diabet Med. 1991 Aug-Sep;8(7):619-23. doi: 10.1111/j.1464-5491.1991.tb01667.x.
Clinically detectable microvascular complications of diabetes are uncommon in children with diabetes especially in the prepubertal group. It is unclear whether subtle functional abnormalities of the microcirculation occur in children without evidence of clinical microangiopathy and in particular whether abnormalities can be demonstrated in children before puberty. The maximum hyperaemic response to direct local heating (44 degrees C) of the foot skin was measured by laser Doppler fluximetry in 50 diabetic and 50 non-diabetic children. An impaired hyperaemic response occurred in the diabetic children compared with control children (diabetic 1.25 (95% CI 1.13-1.37) V; control 1.74 (1.60-1.88) V; p less than 0.001) and was significantly related to duration of diabetes but not to long-term blood glucose control. The impaired response was also present in prepubertal diabetic children (diabetic 1.37 (1.16-1.58) V; control 1.89 (1.67-2.12) V; p less than 0.001). Systolic and diastolic blood pressure were significantly raised in the prepubertal diabetic children. These data suggest that a functional abnormality of the microcirculation occurs in children with diabetes in the absence of clinically detectable microangiopathy, and even before puberty.
糖尿病的临床可检测微血管并发症在糖尿病儿童中并不常见，尤其是在青春期前组。目前尚不清楚在没有临床微血管病变证据的儿童中是否存在微循环的细微功能异常，特别是在青春期前儿童中是否能证实存在异常。通过激光多普勒血流仪测量了50名糖尿病儿童和50名非糖尿病儿童足部皮肤直接局部加热（44摄氏度）后的最大充血反应。与对照儿童相比，糖尿病儿童的充血反应受损（糖尿病儿童为1.25（95%CI 1.13 - 1.37）V；对照儿童为1.74（1.60 - 1.88）V；p<0.001），并且与糖尿病病程显著相关，但与长期血糖控制无关。青春期前糖尿病儿童也存在反应受损（糖尿病儿童为1.37（1.16 - 1.58）V；对照儿童为1.89（1.67 - 2.12）V；p<0.001）。青春期前糖尿病儿童的收缩压和舒张压显著升高。这些数据表明，在没有临床可检测微血管病变的糖尿病儿童中，甚至在青春期前，就存在微循环的功能异常。
