跛行患者（伴或不伴糖尿病）的运动平板试验。

Exercise treadmill testing in patients with claudication, with and without diabetes.

机构信息

Department of Physiology and Vascular Investigations, University Hospital UMR INSERM 771 - CNRS 6214, France.

出版信息

Diabet Med. 2011 Mar;28(3):356-62. doi: 10.1111/j.1464-5491.2010.03208.x.

DOI:10.1111/j.1464-5491.2010.03208.x

PMID:21309846

Abstract

AIM

To compare symptoms and walking capacities of patients with and without diabetes reporting vascular-type claudication.

METHODS

We recorded self-reported maximal walking distance, maximal walking distance on treadmill test (3.2 km h(-1) , 10% slope), exercise transcutaneous oxygen pressure DROP index [limb transcutaneous oxygen pressure (TcpO2) changes from rest minus chest TcpO2 changes from rest] and symptoms on treadmill in 230 patients with diabetes and 982 patients without diabetes. Exercise-induced proximal and distal symptoms were analysed in the perspective of underlying proximal and distal ischaemia (DROP value < negative 15 mmHg).

RESULTS

Self-reported maximal walking distance did not differ between groups, whereas maximal walking distance on treadmill test was lower in patients with diabetes vs. patients without diabetes (261 ± 257 and 339 ± 326 m, respectively; P < 0.05 when adjusted for potential confounders). In patients with ischaemia, the number of ischaemic areas (proximal and/or distal on right and/or left) was comparable between the two groups. Patients with diabetes had more distal ischaemia than patients without diabetes (38 vs. 29%, respectively; P < 0.01), whereas proximal ischaemia was similar between groups. The prevalence of lower-limb exercise-related symptoms without ischaemia was comparable between groups. There were more symptoms other than lower-limb pain in patients with diabetes than patients without diabetes (29.6 vs. 18.3%, respectively; P < 0.01).

CONCLUSIONS

Patients with diabetes show more severe limitation on the treadmill and more non-limb symptoms than patients without diabetes, although self-reported walking capacity is comparable between the two groups. Using TcpO2, we confirm that patients with diabetes reporting claudication show more distal ischaemia than patients without diabetes, with no difference at the buttock level. Treadmill testing is of interest in patients with peripheral artery disease and diabetes.

摘要

目的

比较报告血管性跛行的糖尿病和非糖尿病患者的症状和步行能力。

方法

我们记录了 230 例糖尿病患者和 982 例非糖尿病患者的自我报告最大步行距离、跑步机测试的最大步行距离（3.2km/h，10%坡度）、运动经皮氧分压下降指数[肢体经皮氧分压（TcpO2）从休息时的变化减去胸部 TcpO2 从休息时的变化]以及跑步机上的症状。从潜在的近端和远端缺血的角度分析了运动引起的近端和远端症状（DROP 值<负 15mmHg）。

结果

自我报告的最大步行距离在两组之间没有差异，而糖尿病患者的跑步机测试最大步行距离低于非糖尿病患者（分别为 261±257 和 339±326m；在调整了潜在混杂因素后，P<0.05）。在有缺血的患者中，两组的缺血区域数量（右侧和/或左侧的近端和/或远端）相似。糖尿病患者的远端缺血比例高于非糖尿病患者（分别为 38%和 29%；P<0.01），而两组的近端缺血比例相似。无缺血的下肢运动相关症状的患病率在两组之间相似。糖尿病患者的下肢以外的症状多于非糖尿病患者（分别为 29.6%和 18.3%；P<0.01）。