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糖尿病患者下肢经皮氧分压的预测因素

Predictors of transcutaneous oxygen tension in the lower limbs of diabetic subjects.

作者信息

Boyko E J, Ahroni J H, Stensel V L, Smith D G, Davignon D R, Pecoraro R E

机构信息

Medical Service, Veterans Affairs Medical Centre, Seattle, Washington 98108, USA.

出版信息

Diabet Med. 1996 Jun;13(6):549-54. doi: 10.1002/(SICI)1096-9136(199606)13:6<549::AID-DIA126>3.0.CO;2-R.

Abstract

We examined neuropathy, ankle pressure index (API), and other factors as predictors of transcutaneous oxygen (TcPO2) in the lower limbs of 657 diabetic subjects. Eligible subjects underwent a clinical assessment that included three standard measures of autonomic neuropathy. TcPO2 measurements were performed at 37 degrees C and 44 degrees C at four lower limb locations. Associations between potential predictors and TcPO2 were tested using univariate and multivariate statistics. Mean TcPO2 at any site did not differ by presence of autonomic neuropathy at either temperature, except for a significantly lower value at 44 degrees C below the knee (56.5 versus 59.2 mmHg, p = 0.021). In multivariate analysis, autonomic neuropathy was significantly and independently related to leg 44 degrees C TcPO2 only (coefficient = -2.6734, p = 0.0182). Much stronger associations were seen between TcPO2 and age, ankle blood pressure, and relative body weight on the plantar foot; and between API, glycosylated haemoglobin, ankle blood pressure, and pedal oedema on the dorsal foot and leg. We conclude that factors related to lower limb TcPO2 vary depending on measurement site. Autonomic neuropathy is not an important determinant of TcPO2 in the feet of diabetic subjects. Although several predictors of TcPO2 were identified, most of the variance of this measurement remains unexplained.

摘要

我们研究了神经病变、踝压指数(API)及其他因素,以作为657名糖尿病患者下肢经皮氧分压(TcPO2)的预测指标。符合条件的受试者接受了一项临床评估,其中包括三项自主神经病变的标准检测。在四个下肢部位分别于37摄氏度和44摄氏度测量TcPO2。使用单变量和多变量统计方法测试潜在预测指标与TcPO2之间的关联。在任何一个温度下,自主神经病变的存在与否均未导致任何部位的平均TcPO2出现差异,但在膝盖以下44摄氏度时,平均TcPO2值显著更低(56.5对59.2 mmHg,p = 0.021)。在多变量分析中,自主神经病变仅与腿部44摄氏度时的TcPO2显著且独立相关(系数 = -2.6734,p = 0.0182)。在足底,TcPO2与年龄、踝部血压及相对体重之间的关联更强;在足背和腿部,API、糖化血红蛋白、踝部血压及足部水肿之间的关联更强。我们得出结论,与下肢TcPO2相关的因素因测量部位而异。自主神经病变并非糖尿病患者足部TcPO2的重要决定因素。尽管已确定了几个TcPO2的预测指标,但该测量值的大部分变异仍无法解释。

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