Fushimi H, Inoue T, Nishikawa M, Matsuyama Y, Kitagawa J
Diabetes Res Clin Pract. 1985 Aug;1(2):103-7. doi: 10.1016/s0168-8227(85)80035-8.
Autonomic neuropathy, especially sympathicopathy, a life-threatening complication of diabetes mellitus, has been difficult to evaluate, and remains undetermined. We studied the thermographic patterns of 62 patients (50-69 years old), revealing the vasodilated activities of one leg by immersing the other leg in a warm water bath, for the detection of sympathetic neuropathy, using Thermoviewer MDJTG-MD. The normal pattern shows an increase in skin temperature, while the flat pattern shows no rise or even a paradoxical decrease. The latter had a significantly longer duration of diabetes and poor blood sugar control. The thermographic pattern is closely related to microangiopathy, R-R interval variation and motor nerve conduction velocity. However, R-R interval variation is often abnormal in patients with normal thermographic patterns, showing vasosympathetic abnormalities appearing far later in the development of diabetic neuropathy. The flat pattern develops slowly after at least several years of poor blood sugar control. Change in the pattern is also gradual and slow. The reproducibility of the pattern is excellent and requires relatively simple and noninvasive techniques. Thermography is one of the most reliable, reproducible and noninvasive indexes for finding and following diabetic sympathetic abnormalities.
自主神经病变，尤其是交感神经病变，是糖尿病的一种危及生命的并发症，一直难以评估，目前仍未明确。我们研究了62名年龄在50至69岁之间患者的热成像模式，通过将一条腿浸入温水浴中，利用Thermoviewer MDJTG - MD检测另一条腿的血管舒张活动，以检测交感神经病变。正常模式表现为皮肤温度升高，而平坦模式则无升高甚至出现反常下降。后者的糖尿病病程明显更长，血糖控制不佳。热成像模式与微血管病变、R - R间期变异和运动神经传导速度密切相关。然而，热成像模式正常的患者R - R间期变异常常异常，表明血管交感神经异常在糖尿病神经病变发展过程中出现得要晚得多。平坦模式在血糖控制不佳至少数年之后缓慢发展。模式变化也是渐进且缓慢的。该模式的可重复性极佳，且需要相对简单的非侵入性技术。热成像术是发现和追踪糖尿病交感神经异常最可靠、可重复且非侵入性的指标之一。
