Westerman R A, Widdop R E, Hannaford J, Hogan C, Roberts R, Zimmet P
Department of Physiology, Monash University, Clayton, Vic.
Clin Exp Neurol. 1987;24:129-37.
This paper describes the value of non-invasive neurovascular function tests in the clinical setting. Painful transcutaneous electrical nerve stimulation (TENS) of the dorsum of the foot evoked axon reflex vasodilatation, measured by laser Doppler flowmetry. In addition, acetylcholine and sodium nitrite (NaNO2) were iontophoresed to cause vasodilatation by endothelium-dependent and -independent mechanisms, respectively. Compared with healthy volunteers, diabetic patients with clinically diagnosed neuropathy showed reduced electrical axon reflex flare responses. These responses in one additional subject were absent in a region of denervated skin. Acetylcholine responses, but not NaNO2 responses, were also depressed in patients with diabetic neuropathy. Such reduced cutaneous nocifensor functions may contribute to some symptoms and complications of diabetes mellitus.
本文描述了非侵入性神经血管功能测试在临床环境中的价值。通过激光多普勒血流仪测量，对足部背侧进行疼痛性经皮电神经刺激（TENS）可诱发轴突反射性血管舒张。此外，分别通过离子电渗法给予乙酰胆碱和亚硝酸钠（NaNO2），以通过内皮依赖性和非依赖性机制引起血管舒张。与健康志愿者相比，临床诊断为神经病变的糖尿病患者的电轴突反射耀斑反应减弱。在一名额外受试者中，去神经支配皮肤区域不存在这些反应。糖尿病神经病变患者的乙酰胆碱反应（而非NaNO2反应）也受到抑制。这种皮肤伤害性防御功能的降低可能导致糖尿病的一些症状和并发症。
