Vogelberg K H, Mayer P, König M
Klinische Abteilung des Diabetes-Forschungs-Instituts, Universität Düsseldorf.
Klin Wochenschr. 1990 Jun 19;68(12):588-93. doi: 10.1007/BF01660955.
Doppler sonographic examination of 51 diabetic subjects showed that the macrovascular hyperemic response of the pedal blood flow was negatively correlated to the duration of the disease (p less than 0.01). In comparison with non-diabetic controls (n = 20), the response was increased by more than 210% in newly detected diabetics, but decreased by more than 20% in long-term diabetics. Vascular response was correlated also not only to the duration of the diabetes, but to peripheral neuropathy (p less than 0.001). The hyperemic response was reduced in patients with reduced nerve conduction time, or somatic neuropathy (142 + 152%, p less than 0.005), and in patients with reduced arterial pulsation, or autonomic neuropathy (152 + 88, p less than 0.005), both in comparison with non-diabetic controls (293 +/- 108%). The frequency of decreased macrovascular hyperemic response was in agreement with somatic neuropathy in 69.7% and with autonomic neuropathy in 75.8% of all patients. The results demonstrate that the macrovascular hyperemic response of blood flow in diabetic feet is already reduced at an early stage of peripheral neuropathy without peripheral vascular occlusive disease. The functional reduction of pedal blood flow may be important for the development of diabetic foot gangrene.
对51名糖尿病患者进行的多普勒超声检查显示，足部血流的大血管充血反应与疾病持续时间呈负相关（p<0.01）。与非糖尿病对照组（n = 20）相比，新诊断的糖尿病患者的反应增加了210%以上，但长期糖尿病患者的反应减少了20%以上。血管反应不仅与糖尿病持续时间相关，还与周围神经病变相关（p<0.001）。与非糖尿病对照组（293±108%）相比，神经传导时间缩短或存在躯体神经病变的患者（142+152%，p<0.005）以及动脉搏动减弱或存在自主神经病变的患者（152+88，p<0.005）的充血反应均降低。在所有患者中，大血管充血反应降低的频率与躯体神经病变的符合率为69.7%，与自主神经病变的符合率为75.8%。结果表明，在无周围血管闭塞性疾病的周围神经病变早期，糖尿病足的大血管充血反应就已经降低。足部血流的功能降低可能对糖尿病足坏疽的发生发展具有重要意义。
