Local sensory nerve control of skin blood flow during local warming in type 2 diabetes mellitus.
Local sensory nerve control of skin blood flow during local warming in type 2 diabetes mellitus.
复制标题
2 型糖尿病局部变暖期间局部感觉神经对皮肤血流的控制。
DOI：
10.1152/japplphysiol.01077.2009
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Charkoudian,Nisha
中科院分区：
文献类型：
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作者：
Strom,NicholasA;Sawyer,JessicaR;Roberts,ShellyK;Kingsley-Berg,ShirleyM;Charkoudian,Nisha
皮肤感觉神经介导的血管舒张是正常微血管对热和非热刺激反应的重要组成部分。由于2型糖尿病（T2 DM）的神经和微血管功能均受损，因此我们检验了以下假设：与年龄和体型匹配的健康对照组（C）相比，T2 DM患者在无疼痛局部皮肤变暖期间局部感觉神经介导的血管舒张较少。在此局部升温的第一个0.5min期间的快速血管舒张（“初始峰值”）先前显示主要依赖于局部感觉神经。我们测量了T2 DM和C受试者（每组n= 7）在基线和局部皮肤加温至42°C 35分钟期间前臂腹侧两个部位的皮肤血流量。一个部位用4%利多卡因（LIDO）预处理以阻断局部感觉神经支配。在局部加温过程中，两组间初始峰值时的皮肤血管传导性（CVC）无差异，无论是在未治疗部位[T2 DM 75 ± 2 vs. C 81 ± 6%maxCVC（%maxCVC）;P> 0.05]还是在LIDO部位（T2 DM 63 ± 7 vs. C 64 ± 6%maxCVC;P> 0.05）。两组之间未治疗和LIDO部位之间的差异（感觉神经贡献）也相似（T2 DM 13 ± 5 vs. C 18 ± 5%maxCVC;P> 0.05），LIDO组的差异小于先前使用其他局麻药时的差异。我们的研究结果表明，与年龄和体型相似的对照组相比，相对健康的T2 DM患者在热刺激期间局部感觉神经血管舒张未表现出受损。
Cutaneous sensory nerve-mediated vasodilation is an important component of normal microvascular responsiveness to thermal and nonthermal stimuli. Since both neural and microvascular function can be impaired in type 2 diabetes mellitus (T2DM), we tested the hypothesis that local sensory nerve-mediated vasodilation during nonpainful local warming of the skin is less in T2DM compared with healthy controls (C) matched for age and body size. The rapid vasodilation during the first ∼5 min of this local warming (“initial peak”) was previously shown to rely primarily on local sensory nerves. We measured skin blood flow in T2DM and C subjects (n= 7 in each group) at baseline and during 35 min of local warming of the skin to 42°C at two sites on the ventral forearm. One site was pretreated with 4% lidocaine (LIDO) to block local sensory innervation. During local warming, cutaneous vascular conductance (CVC) during the initial peak was not different between groups, either at the untreated site [T2DM 75 ± 2 vs. C 81 ± 6% of maximum CVC (%maxCVC);P> 0.05] or at the LIDO site (T2DM 63 ± 7 vs. C 64 ± 6%maxCVC;P> 0.05). The difference between untreated and LIDO sites (sensory nerve contribution) was also similar between groups (T2DM 13 ± 5 vs. C 18 ± 5%maxCVC;P> 0.05) and was smaller with LIDO than was previously shown with other local anesthetics. Our results suggest that relatively healthy individuals with T2DM do not exhibit impairments in local sensory nerve vasodilation during thermal stimulation compared with controls of similar age and body size.