Gilmore J E, Allen J A, Hayes J R
School of Basic Medical Sciences, Queen's University of Belfast, Northern Ireland.
Diabetes Care. 1993 Jan;16(1):61-7. doi: 10.2337/diacare.16.1.61.
The aim of this study was to compare peripheral autonomic function in neuropathic diabetic subjects with and without foot ulceration.
Measurements were made on 57 diabetic subjects; 35 subjects had evidence of peripheral neuropathy, 14 of these had a history of foot ulceration, and 22 subjects had no evidence of peripheral neuropathy. No patient had peripheral vascular disease. Measurements were made of motor and sensory nerve conduction. Autonomic function was investigated by using standard cardiovascular reflex tests and by measuring blood flow variability in the foot. The vasoconstrictor responses to deep breathing and body cooling were measured by using venous occlusion plethysmography.
Peripheral sympathetic function was significantly worse in the DU group. The vasoconstrictor response to deep breathing in the DU group was significantly smaller than the response in the DN group (15.3 +/- 2.7 vs. 38 +/- 4%, P < 0.001). The response to body cooling in the DU group was significantly smaller than the response in the DN group (6.2 +/- 3.1 vs. 20.8 +/- 3.5%, P < 0.01). Tests of cardiac autonomic function and measurements of motor and sensory nerve conduction were similar in both neuropathic groups.
Peripheral autonomic neuropathy is associated with the development of foot ulceration in diabetic subjects.
本研究旨在比较有和没有足部溃疡的糖尿病神经病变患者的外周自主神经功能。
对57例糖尿病患者进行了测量；35例有外周神经病变证据，其中14例有足部溃疡病史，22例无外周神经病变证据。所有患者均无外周血管疾病。测量了运动和感觉神经传导。通过标准心血管反射试验和测量足部血流变异性来研究自主神经功能。使用静脉阻塞体积描记法测量对深呼吸和身体降温的血管收缩反应。
糖尿病足部溃疡（DU）组的外周交感神经功能明显更差。DU组对深呼吸的血管收缩反应明显小于糖尿病神经病变（DN）组（15.3±2.7对38±4%，P<0.001）。DU组对身体降温的反应明显小于DN组（6.2±3.1对20.8±3.5%，P<0.01）。两组神经病变患者的心脏自主神经功能测试以及运动和感觉神经传导测量结果相似。
外周自主神经病变与糖尿病患者足部溃疡的发生有关。
