Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Sweden.
Diab Vasc Dis Res. 2011 Apr;8(2):136-42. doi: 10.1177/1479164111404576.
Diabetes mellitus is associated with decreased haemodynamic stability and reduced tolerance to hypovolaemia. Compensatory haemodynamic responses during experimental hypovolaemia in type 1 diabetes patients with (DMR+) and without (DMR-) retinopathy as well as healthy controls (C) were studied. Lower body negative pressure created hypovolaemic circulatory stress. Volumetric techniques were used to assess the compensatory capacitance response (redistribution of peripheral venous blood to the central circulation) and to assess capillary fluid absorption from tissue to blood. The compensatory capacitance response was 1/3 lower in DMR+ compared with C (p = 0.002) and DMR- (p = 0.01). Net capillary fluid absorption was reduced by one-third in DMR- and DMR+ compared with C (each p < 0.05). Type 1 diabetes patients with retinopathy demonstrate reduced mobilisation of peripheral venous blood to the central circulation. Furthermore, type 1 diabetes patients present with impaired capillary fluid absorption, which in combination with potentially decreased sympathetic vasoconstriction impedes cardiovascular homeostasis during acute hypovolaemic stress.
糖尿病与血流动力学稳定性降低和对低血容量的耐受性降低有关。研究了伴有（DMR+）和不伴有（DMR-）视网膜病变的 1 型糖尿病患者以及健康对照者（C）在实验性低血容量期间的代偿性血流动力学反应。下体负压造成低血容量循环应激。容量技术用于评估代偿性容量反应（外周静脉血向中心循环的再分布）和评估从组织到血液的毛细血管液体吸收。与 C 相比，DMR+的代偿性容量反应降低了 1/3（p=0.002），与 DMR-相比也降低了 1/3（p=0.01）。与 C 相比，DMR-和 DMR+的净毛细血管液体吸收减少了 1/3（均 p<0.05）。伴有视网膜病变的 1 型糖尿病患者外周静脉血向中心循环的动员减少。此外，1 型糖尿病患者的毛细血管液体吸收受损，这与潜在的交感神经血管收缩功能降低相结合，在急性低血容量应激期间阻碍了心血管内稳态。
