Flynn M D, Tooke J E
Department of Diabetes and Endocrinology, Prince Philip Hospital, Llanelli, Dyfed, UK.
Diabet Med. 1995 Apr;12(4):298-301. doi: 10.1111/j.1464-5491.1995.tb00480.x.
There is a close relationship between the abnormal microcirculation in diabetic subjects and diabetic neuropathy. Neurogenic factors play a prominent role in the regulation of the microcirculation. In diabetic neuropathy, damage to these mechanisms results in a profound haemodynamic disturbance with increased arteriovenous shunting, abnormal postural regulation of blood flow, and abnormal inflammatory responses to tissue injury. Abnormal neurogenic regulation of microvascular haemodynamics may contribute to the development of microangiopathy manifest as increased basement thickening and both are undoubtedly implicated in the pathogenesis of diabetic foot ulceration. In turn it is now recognized that microvascular abnormalities may contribute to the ischaemic aetiology of diabetic neuropathy.
糖尿病患者的微循环异常与糖尿病神经病变之间存在密切关系。神经源性因素在微循环调节中起显著作用。在糖尿病神经病变中，这些机制受损会导致严重的血流动力学紊乱，表现为动静脉分流增加、血流的姿势调节异常以及对组织损伤的炎症反应异常。微血管血流动力学的神经源性调节异常可能导致微血管病变的发展，表现为基底膜增厚增加，而这两者无疑都与糖尿病足溃疡的发病机制有关。反过来，现在人们认识到微血管异常可能导致糖尿病神经病变的缺血病因。
