Grover-Johnson N, Baumann F G, Riles T S, Imparato A M
Surg Gynecol Obstet. 1981 Jul;153(1):39-41.
The innervation of lower limb epineurial arterioles, specimens of which were obtained from six patients in the sympathectomy and from six patients in the nonsympathectomy diabetic groups at amputation for ischemic peripheral vascular disease, was compared by quantitative ultrastructural methods. Results demonstrated no statistically significant difference in the number of vasomotor axons present, the average axon to smooth muscle cell distance or the axon distribution pattern in the adventitia between the two diabetic groups of patients. A previous investigation has established that innervation of these arterioles is significantly reduced in patients with diabetes having end-stage ischemia of the lower limb when compared with similar patients without diabetes. The present results demonstrate that surgical lumbar sympathectomy does not significantly further reduce the already severely diminished number of vasomotor nerves in some diabetic arterioles. This observation offers a possible explanation for the poorer success rate of those with diabetes compared with those without diabetes in avoiding amputation of the limb after lumbar sympathectomy.
通过定量超微结构方法，对下肢神经外膜小动脉的神经支配情况进行了比较。这些小动脉标本取自6例接受交感神经切除术的患者以及6例未接受交感神经切除术的糖尿病患者，这些患者因缺血性外周血管疾病而接受截肢手术。结果显示，两组糖尿病患者之间，在存在的血管运动轴突数量、轴突与平滑肌细胞的平均距离或外膜中的轴突分布模式方面，均无统计学上的显著差异。先前的一项研究已证实，与无糖尿病的类似患者相比，患有下肢终末期缺血的糖尿病患者，这些小动脉的神经支配显著减少。目前的结果表明，手术性腰交感神经切除术并不会进一步显著减少某些糖尿病小动脉中本已严重减少的血管运动神经数量。这一观察结果为糖尿病患者在腰交感神经切除术后避免肢体截肢方面，相较于非糖尿病患者成功率较低提供了一种可能的解释。
