BLOOD-FLOW IN THE FOOT, POLYNEUROPATHY AND FOOT ULCERATION IN DIABETES-MELLITUS
BLOOD-FLOW IN THE FOOT, POLYNEUROPATHY AND FOOT ULCERATION IN DIABETES-MELLITUS
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DOI：
10.1007/bf00279614
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发表时间：
1987-07-01
期刊：
影响因子：
8.2
通讯作者：
CLARKE, BF
中科院分区：
文献类型：
--
作者：
CORBIN, DOC;YOUNG, RJ;CLARKE, BF
比较无症状神经病变的糖尿病患者（A组）、慢性疼痛性多神经病变（B组）和无痛性多神经病变引起复发性足部溃疡（C组）的足血流、周围躯体和自主神经病变及血管钙化的差异。多普勒波形分析检测到血流异常，与周围血管阻力降低一致，在所有三组糖尿病患者中均发现。A组和B组的异常程度相似，但C组的异常程度普遍更明显。从A组到C组，外周躯体神经功能的测试逐渐变得异常。B组和C组的自主神经病变同样严重，尽管在无神经病变症状的糖尿病患者中有轻微异常记录。跗骨和跖动脉的血管钙化也有类似的模式：在两组神经性病变（B组和C组）中都很明显，但在A组中比较轻微。由此得出结论，无论是否有神经性病变症状，糖尿病患者的足部都很常见与外周血管阻力降低相一致的异常血流，在慢性无痛性多发性神经病和复发性足部溃疡患者中最为严重。自主神经功能障碍与血流异常程度无明显关系。
Comparable groups of diabetic patients asymptomatic of neuropathy (Group A), with chronic painful polyneuropathy (Group B) and painless polyneuropathy causing recurrent foot ulceration (Group C) were studied for differences in pedal blood flow, peripheral somatic and autonomic neuropathy and vascular calcification. Blood flow abnormalities detected by doppler waveform analysis, and consistent with reduced peripheral vascular resistance, were found in all three diabetic patient groups. The abnormalities were of similar severity in Group A and B but generally more marked in Group C. Tests of peripheral somatic nerve function became progressively more abnormal from Group A to Group C. Autonomic neuropathy was equally severe in Groups B and C, although mild abnormalities were recorded in diabetic patients asymptomatic of neuropathy. A similar pattern was seen for vascular calcification in the tarsal and metatarsal arteries: marked in both neuropathic groups (B and C) but mild in Group A. It was concluded that abnormal blood flow consistent with reduced peripheral vascular resistance is very common in the feet of diabetic patients whether or not they are symptomatic of neuropathy, and is most severe in those with chronic painless polyneuropathy and recurrent foot ulceration. No clear relationship was found between autonomic nerve dysfunction and the degree of abnormality of blood flow.