Biro Katalin, Sandor Barbara, Kovacs David, Csiszar Beata, Vekasi Judit, Totsimon Kinga, Toth Andras, Koltai Katalin, Endrei Dora, Toth Kalman, Kesmarky Gabor
First Department of Medicine, University of Pecs, Medical School, Hungary.
Department of Ophthalmology, University of Pecs, Medical School, Hungary.
Clin Hemorheol Microcirc. 2018;69(1-2):23-35. doi: 10.3233/CH-189103.
Diabetes mellitus is frequently associated with vascular pathologies and hemorheological disorders.
105 patients with diabetic retinopathy (DRP) (mean age 64.64±9.01 years, 56 males, 49 females), 35 age-matched non-diabetic (mean age 61.65±7.6 years, 14 males and 21 females) and 42 young healthy volunteers (mean age 25.52±3.32 years, 22 males, 20 females) were recruited. Lower extremity artery disease (LEAD) and microcirculatory alterations were screened by hand-held Doppler, transcutaneous partial tissue oxygen tension (tcpO2), tuning fork test, 6-minute walk test, erythrocyte aggregation and deformability.
High prevalence of LEAD was detected in diabetic population: 55.3% fulfilled the criteria of LEAD based on ankle-brachial index; severely impaired tcpO2 was measured in 18.6%. The results of non-invasive measurements of the diabetic patients were significantly worse than those of the control groups (p < 0.05). Hemorheological disturbances could be characterized by the significantly higher erythrocyte aggregation (p < 0.05) and lower erythrocyte deformability (p < 0.05) in the diabetic population.
Macro- and microcirculatory lower limb disorders could be revealed at high prevalence in diabetic patients with retinopathy. Measurement of tcpO2 and hemorheological variables could be useful to discover patients at higher risk for diabetic foot complications.
糖尿病常与血管病变和血液流变学紊乱相关。
招募了105例糖尿病视网膜病变（DRP）患者（平均年龄64.64±9.01岁，男性56例，女性49例）、35例年龄匹配的非糖尿病患者（平均年龄61.65±7.6岁，男性14例，女性21例）和42例年轻健康志愿者（平均年龄25.52±3.32岁，男性22例，女性20例）。通过手持式多普勒、经皮局部组织氧分压（tcpO2）、音叉试验、6分钟步行试验、红细胞聚集和变形性来筛查下肢动脉疾病（LEAD）和微循环改变。
在糖尿病患者群体中检测到LEAD的高患病率：基于踝臂指数，55.3%的患者符合LEAD标准；18.6%的患者测量到tcpO2严重受损。糖尿病患者的非侵入性测量结果明显比对照组差（p<0.05）。血液流变学紊乱的特征是糖尿病患者群体中红细胞聚集显著更高（p<0.05）和红细胞变形性更低（p<0.05）。
在患有视网膜病变的糖尿病患者中，大循环和微循环下肢疾病的患病率较高。测量tcpO2和血液流变学变量可能有助于发现糖尿病足并发症风险较高的患者。
