Schaper N C, Huijberts M, Pickwell K
Department of Internal Medicine, Division of Endocrinology, University Hospital Maastricht, The Netherlands.
Diabetes Metab Res Rev. 2008 May-Jun;24 Suppl 1:S40-4. doi: 10.1002/dmrr.862.
Loss of pain perception is currently seen as a key factor in the development of diabetic foot ulcers. However, recent studies suggest that nerves play a central role in tissue homeostasis and can orchestrate complex reparative as well as destructive processes in the feet. Evidence is presented that suggests that denervation can result in altered capillary blood flow (in patients with type 2 diabetes), oxygen delivery, fluid filtration, and inflammatory responses. These processes could render the feet of diabetic patients with neuropathy more susceptible to tissue damage, infection and perhaps, in a subset of patients, to the development of acute Charcot neuro-osteoarthropathy (CN).
目前，痛觉丧失被视为糖尿病足溃疡发生发展的关键因素。然而，最近的研究表明，神经在组织稳态中起核心作用，并且能够协调足部复杂的修复以及破坏过程。有证据表明，去神经支配可导致（2型糖尿病患者）毛细血管血流、氧气输送、液体滤过和炎症反应发生改变。这些过程可能使患有神经病变的糖尿病患者的足部更容易受到组织损伤、感染，并且在一部分患者中，可能更容易发生急性夏科氏神经关节病（CN）。
