Rayman G, Williams S A, Gamble J, Tooke J E
Department of Physiology, Charing Cross and Westminster Medical School, London, UK.
Eur J Clin Invest. 1994 Dec;24(12):830-6. doi: 10.1111/j.1365-2362.1994.tb02027.x.
The effect of lowering the foot on the factors governing fluid filtration in the foot were studied in 12 male insulin-dependent diabetic subjects and 10 controls. Toe skin blood flow, measured by laser Doppler flowmetry, was significantly higher during dependency in the diabetic group. In the control subjects, the colloid osmotic pressure of venous blood sampled from the foot rose to 47.7 mmHg (range 45.1-53.8) after 50 min of foot dependency. In the diabetic group, colloid osmotic pressure failed to rise to the same extent (median 36.7 mmHg; range 28.6-43.0; P < 0.001). Capillary pressure, measured directly by the Landis microinjection technique, was significantly higher in the diabetic group (85.3 +/- 1.7 (n = 6) vs. 92.2 +/- 4.6 cm H2O (n = 6); P < 0.007), as was foot swelling rate determined by mercury strain gauge plethysmography (0.069 +/- 0.022 vs. 0.099 +/- 0.025 ml min-1 100 ml-1; P < 0.02). These results suggest an impairment of the oedema-preventing mechanisms in diabetic subjects which may contribute to the risks of ulceration in the diabetic foot.
在12名男性胰岛素依赖型糖尿病患者和10名对照者中，研究了足部下垂对足部液体滤过相关因素的影响。通过激光多普勒血流仪测量，糖尿病组在足部下垂时趾部皮肤血流显著更高。在对照组中，足部下垂50分钟后，从足部采集的静脉血胶体渗透压升至47.7 mmHg（范围45.1 - 53.8）。在糖尿病组中，胶体渗透压未能升至相同程度（中位数36.7 mmHg；范围28.6 - 43.0；P < 0.001）。通过兰迪斯微量注射技术直接测量的毛细血管压力，糖尿病组显著更高（85.3 ± 1.7（n = 6）对92.2 ± 4.6 cmH₂O（n = 6）；P < 0.007），通过汞应变仪体积描记法测定的足部肿胀率也是如此（0.069 ± 0.022对0.099 ± 0.025 ml·min⁻¹·100 ml⁻¹；P < 0.02）。这些结果表明糖尿病患者预防水肿的机制受损，这可能导致糖尿病足溃疡风险增加。
