FOOT PRESSURE MEASUREMENTS IN DIABETIC AND NONDIABETIC AMPUTEES
FOOT PRESSURE MEASUREMENTS IN DIABETIC AND NONDIABETIC AMPUTEES
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DOI：
10.2337/diacare.15.7.905
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发表时间：
1992-07-01
期刊：
影响因子：
16.2
通讯作者：
BOULTON, AJM
中科院分区：
文献类型：
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作者：
VEVES, A;VANROSS, ERE;BOULTON, AJM
目的：糖尿病截肢者的剩余足部常见足部问题。因为高足压与足部溃疡有关，我们研究了糖尿病和非糖尿病单侧截肢者的残足压力。研究设计和方法：研究对象为4个年龄匹配的11名受试者。这些组包括既往有重大截肢史的糖尿病患者、非糖尿病非神经性截肢者、与糖尿病截肢者周围神经受累相似的糖尿病非截肢者和非糖尿病对照组。结果糖尿病截肢者振动觉阈值显著高于非糖尿病截肢者(40.2+/-3.7vs.17.7+/-2.8V，P<；0.002)，与糖尿病非截肢者(43.4+/-3.3V，NS)相似。糖尿病截肢者VPT异常9例(82%)，非糖尿病截肢者2例(18%)，非截肢者10例(91%)。糖尿病截肢者的平均足底峰值压力高于非糖尿病截肢者(18.3±-2.2比11.3±1.4 kg/cm2，P<；0.05)和对照组(10.0±1.5 kg/m2，P<；0.01)，但与糖尿病非截肢者差异无统计学意义。糖尿病截肢者8例(73%)，非糖尿病截肢者3例(27%)，糖尿病非截肢者8例(73%)，健康人4例(36%)。结论：我们得出结论：糖尿病截肢者的残足存在高压，这些压力与糖尿病神经病变有关。在非糖尿病截肢者中，假体的使用不会增加剩余足部的压力。
OBJECTIVE - Foot problems are common in the remaining foot of diabetic amputees. Because high foot pressures are associated with foot ulceration, we studied foot pressures of the remaining foot of diabetic and nondiabetic unilateral amputees.RESEARCH DESIGN AND METHODS - Four age-matched groups of 11 subjects were studied. The groups were comprised of diabetic subjects with previous major amputation, nondiabetic nonneuropathic amputees, diabetic nonamputee patients with similar peripheral nerve involvement as the diabetic amputees, and nondiabetic control subjects. Vibration perception threshold (VPT) was assessed by biothesiometry and foot pressures with an optical pedobarograph.RESULTS - Mean +/- SE VPT in the diabetic amputees was significantly higher than the nondiabetic amputees (40.2 +/- 3.7 vs. 17.7 +/- 2.8 V, P < 0.002) and similar to diabetic nonamputees (43.4 +/- 3.3 V, NS). VPT was abnormal in 9 (82%) diabetic amputees, 2 (18%) nondiabetic amputees, and 10 (91%) nonamputee diabetic patients. The mean peak foot pressure in the diabetic amputees was higher compared with nondiabetic amputees (18.3 +/- 2.2 vs. 11.3 +/- 1.4 kg/cm2, P < 0.05) and control subjects (10.0 +/- 1.5 kg/m2, P < 0.01), but no difference existed with diabetic nonamputees. Abnormally high foot pressures (> 12.3 kg/cm2) were present in 8 (73%) diabetic amputees, 3 (27%) nondiabetic amputees, 8 (73%) diabetic nonamputees, and 4 (36%) healthy subjects.CONCLUSIONS - We conclude that high pressures are present under the remaining foot in diabetic amputees, and that these pressures are associated with diabetic neuropathy. Prosthetic usage does not increase the pressures under the remaining foot in nondiabetic amputees.