Neurovascular Response to Pressure in Patients With Diabetic Foot Ulcer
Neurovascular Response to Pressure in Patients With Diabetic Foot Ulcer
复制标题
糖尿病足溃疡患者对压力的神经血管反应
DOI：
10.2337/db18-0694
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发表时间：
2019-04-01
期刊：
影响因子：
7.7
通讯作者：
Sigaudo-Roussel, Dominique
中科院分区：
文献类型：
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作者：
Vouillarmet, Julien;Josset-Lamaugarny, Audrey;Sigaudo-Roussel, Dominique
糖尿病足溃疡（DFU）是一个世界性的问题，预防至关重要。我们假设皮肤对压力的反应能力与DFU的发病机制有关，可能是一个重要的预测因素。我们纳入了29例DFU患者和30例无DFU的2型糖尿病患者。神经病变和皮肤血流在休息时进行了评估，以响应乙酰胆碱，硝普钠，局部加热（42摄氏度），并以无害的局部施加的压力。结果进行了比较，从10个健康的年龄匹配的对照组。与健康受试者相比，两组糖尿病患者对压力的血管舒张反应均显著受损。DFU患者的血管舒张能力明显低于无DFU患者，尽管皮肤压力感知阈值和血管对乙酰胆碱、硝普钠和热的反应性无显著差异。DFU患者对压力的神经血管反应的这种明显改变是皮肤脆弱性的一个很好的标志，可以用来更好地预测风险个体。
Diabetic foot ulcer (DFU) is a problem worldwide, and prevention is crucial. We hypothesized that the inability of the skin to respond to pressure is involved in DFU pathogenesis and could be an important predictive factor to take into account. We included 29 patients with DFU and 30 patients with type 2 diabetes without DFU. Neuropathy and skin blood flow at rest were assessed in response to acetylcholine, sodium nitroprusside, local heating (42 degrees C), and to nonnoxious locally applied pressure. Results were compared with those obtained from 10 healthy age-matched control subjects. Vasodilatation in response to pressure was significantly impaired in both groups with diabetes compared with healthy subjects. The vasodilator capacity to pressure was significantly lower in patients with DFU compared with those without DFU, despite the absence of significant difference in cutaneous pressure perception threshold and vascular reactivity to acetylcholine, sodium nitroprusside, and heat. This pronounced alteration of neurovascular response to pressure in patients with DFU is a good marker of skin vulnerability and could be used to better predict individuals at risk.