Walmsley D, Wales J K, Wiles P G
University Department of Medicine, General Infirmary, Leeds, UK.
Diabetologia. 1989 Oct;32(10):736-9. doi: 10.1007/BF00274533.
The hyperaemic response to standard needle injury within dorsal foot skin was investigated in normal and Type 1 (insulin-dependent) diabetic subjects using laser Doppler flowmetry. The normal response was maximal within 15 min, localised, prolonged and biphasic. In 20 normal subjects and three groups of long-duration Type 1 diabetic patients (20 without complications; 20 with laser-treated retinopathy; 15 with neuropathy and retinopathy), the median (interquartile range) peak hyperaemic responses were 1.766 (1.220-1.970), 1.485 (1.342-1.672), 0.997 (0.705-1.203) and 1.030 (0.718-1.369) arbitrary units, respectively. Compared to normal and uncomplicated diabetic groups, peak flow was significantly reduced in the retinopathic (p less than 0.0001) and neuropathic (p = 0.001 and 0.007, respectively) groups. There was no significant difference between the normal and uncomplicated diabetic groups, nor between the retinopathic and neuropathic groups. There was no association of the hyperaemic response with blood sugar, HbA1c, or duration of diabetes. Diabetic patients who have microvascular complications, with or without neuropathy, have an associated impairment of microvascular response to mechanical injury which might predispose to infection and poor wound healing.
使用激光多普勒血流仪，对正常受试者和1型（胰岛素依赖型）糖尿病患者足背皮肤标准针刺损伤后的充血反应进行了研究。正常反应在15分钟内达到最大值，具有局限性、持续性和双相性。在20名正常受试者和三组长期1型糖尿病患者（20名无并发症；20名接受激光治疗的视网膜病变患者；15名患有神经病变和视网膜病变患者）中，充血反应峰值的中位数（四分位间距）分别为1.766（1.220 - 1.970）、1.485（1.342 - 1.672）、0.997（0.705 - 1.203）和1.030（0.718 - 1.369）任意单位。与正常组和无并发症糖尿病组相比，视网膜病变组（p < 0.0001）和神经病变组（分别为p = 0.001和0.007）的血流峰值显著降低。正常组和无并发症糖尿病组之间、视网膜病变组和神经病变组之间均无显著差异。充血反应与血糖、糖化血红蛋白或糖尿病病程无关。患有微血管并发症（无论有无神经病变）的糖尿病患者，其对机械损伤的微血管反应存在相关损害，这可能易导致感染和伤口愈合不良。
