Renero-C Francisco-J
Optics - Biomedicine, INAOE, Puebla, Mexico.
Diabet Foot Ankle. 2018 Jan 30;9(1):1430950. doi: 10.1080/2000625X.2018.1430950. eCollection 2018.
One of the complications of the diabetes mellitus is the amputation of the lower limbs. This complication may be developed after an insidious ulcer, that may be raised by the peripheral neuropathy or the ischaemic limb, and that the ulcer get infected. That is, to develop an ulcer, in the diabetic patient, three factors should be taken into the account, the autonomic nervous system, the blood supply and the inmune system. In this work, the thermogram is used to identify regions on the plantar skin with blood supply deficiencies and the behaviour of the thermoregulation process. Within the thermogram of the plantar skin, it can be identify local regions with low and high temperatures that corresponds to ischemic or inflammatory process on that part of the skin. The findings within the 186 thermograms of diabetic patients, obtained from three hospitals and from INAOE facilities, showed, first, the thermograms of the plantar skin of two diabetic patients, acquired in two different times show that the temperature distribution and the average temperatures, vary slightly for a period of weeks. Second, the thermograms of two patients, who both developed insidious ulcers which evolved favourable, demonstrated the importance of the immune system and the drug therapy. These patients are, one who has a Charcot foot, and in the second one, the patient had loss the sensibility of the feet. Finally, the thermograms of two patients, showing abrupt temperature change within small regions in the plantar skin, are discussed. A diabetic patient, with an asymmetric thermogram, as physiological interpretation of the thermoregulation, may indicate a decrease of the blood supply, which may be corroborated by vascular ultrasound. The regions of abrupt temperature change, cold or hot spots, may correspond to ischaemic or inflammatory processes.
糖尿病的并发症之一是下肢截肢。这种并发症可能在隐匿性溃疡后出现，溃疡可能由周围神经病变或肢体缺血引起，并受到感染。也就是说，在糖尿病患者中，要形成溃疡，应考虑三个因素：自主神经系统、血液供应和免疫系统。在这项研究中，热成像图用于识别足底皮肤血液供应不足的区域以及体温调节过程的表现。在足底皮肤的热成像图中，可以识别出对应于皮肤该部位缺血或炎症过程的低温和高温局部区域。从三家医院和INAOE机构获得的186份糖尿病患者热成像图的研究结果表明，首先，两名糖尿病患者在两个不同时间获取的足底皮肤热成像图显示，在数周时间内，温度分布和平均温度略有变化。其次，两名患者都出现了隐匿性溃疡且病情好转，这证明了免疫系统和药物治疗的重要性。这两名患者，一名患有夏科氏足，另一名患者足部失去了感觉。最后，讨论了两名患者足底皮肤小区域内温度突然变化的热成像图。一名糖尿病患者的热成像图不对称，作为体温调节的生理学解释，可能表明血液供应减少，这可以通过血管超声得到证实。温度突然变化的区域，即冷点或热点，可能对应于缺血或炎症过程。
