Osei K, Fields P G, Cataland S, Craig E L, George J M, O'Dorisio T M
Am J Med. 1985 Apr;78(4):595-601. doi: 10.1016/0002-9343(85)90401-2.
The brachial artery pressure and retinal artery pressure responses to a one-minute cold pressor test were evaluated simultaneously in 14 patients with type I diabetes mellitus (six with and eight without diabetic retinopathy) and 10 age-matched control subjects. Five patients with type I diabetes had autonomic neuropathy. Mean baseline brachial artery pressure and retinal artery pressure were similar in patients with type I diabetes and control subjects. After cold pressor testing, the brachial artery pressure increased significantly (p less than 0.01) compared with baseline values in both groups. Retinal mean arterial pressures increased significantly (p less than 0.001) after cold pressor testing compared with the baseline values only in patients with type I diabetes. Positive correlation was found between the brachial and retinal mean arterial pressures after cold pressor testing (r = 0.48; p less than 0.05) in the diabetic patients but not in the control subjects (r = 0.10; p = NS). No correlation was found between the retinal artery pressure and age of onset of diabetes, duration of diabetes, the presence or absence of diabetic retinopathy, and glycemic control. Four patients with autonomic neuropathy and low retinal artery pressures, which remained unchanged after cold pressor testing, had no diabetic retinopathy. The fifth patient with autonomic neuropathy and exaggerated systolic brachial artery pressure (175 mm Hg) and retinal artery pressure (more than 80 mm Hg) responses had severe background diabetic retinopathy. In conclusion, abnormal retinal artery responses to stress are present in patients with type I diabetes. This may be modified by the presence or absence of both autonomic neuropathy and hypertension. The biologic significance of these findings is yet to be determined.
在14例I型糖尿病患者（6例有糖尿病视网膜病变，8例无糖尿病视网膜病变）和10例年龄匹配的对照受试者中，同时评估了对1分钟冷加压试验的肱动脉压力和视网膜动脉压力反应。5例I型糖尿病患者有自主神经病变。I型糖尿病患者和对照受试者的平均基础肱动脉压力和视网膜动脉压力相似。冷加压试验后，两组的肱动脉压力均较基线值显著升高（p<0.01）。仅在I型糖尿病患者中，冷加压试验后视网膜平均动脉压较基线值显著升高（p<0.001）。在糖尿病患者中，冷加压试验后肱动脉和视网膜平均动脉压之间存在正相关（r = 0.48；p<0.05），而在对照受试者中无相关性（r = 0.10；p =无显著性差异）。未发现视网膜动脉压力与糖尿病发病年龄、糖尿病病程、有无糖尿病视网膜病变及血糖控制之间存在相关性。4例有自主神经病变且视网膜动脉压力低的患者，冷加压试验后压力未改变，无糖尿病视网膜病变。第5例有自主神经病变且肱动脉收缩压（175 mmHg）和视网膜动脉压力（超过80 mmHg）反应过度的患者有严重的糖尿病背景视网膜病变。总之，I型糖尿病患者存在应激时异常的视网膜动脉反应。这可能会因自主神经病变和高血压的有无而改变。这些发现的生物学意义尚待确定。
