不同阻断压力和时间对2型糖尿病患者皮肤反应性充血影响的初步比较  

The Methodology Comparison of Skin Postocclusive Reactive Hyperemia in Patients with Diabetes at Different Occlusion Stress and Time

作　　者：傅汉菁[1] 赵静[1] 沈英华[1] 袁申元[1] 

机构地区：[1]首都医科大学附属北京同仁医院内分泌科,北京,100730

出　　处：《微循环学杂志》2009年第1期20-22,共3页Chinese Journal of Microcirculation

摘　　要：目的:观察激光多普勒血流仪(LDF)测定2型糖尿病患者上肢皮肤微血流阻断后反应性充血(PORH)的最佳阻断压力和时间。方法:应用LDF对28例2型糖尿病患者上肢皮肤PORH进行连续三天检测,每天的阻断加压量及持续时间分别为收缩压以上20mmHg/2min、30mmHg/3min以及40mmHg/4min,快速减压,以诱发PORH,比较三种阻断状态对上肢皮肤微血流阻断后最小值PUmin、最大值PUmax及PUmax-PUmin的影响。结果:在以上三种压力和时间状态下,前臂PUmin差异无统计学差异,PUmax及PUmax-PUmin于30mmHg/3min时分别为40.46±17.72和36.04±16.97,与40mmHg/4min时测值(40.39±15.45和36.16±15.56)比较,其差异无统计学意义(P>0.05),但两者明显高于20mmHg/2min时测定结果(28.27±15.48、23.70±15.72,P<0.01)。结论:采用收缩压以上30mmHg/3min,即可使2型糖尿病患者皮肤微血管达到较好的反应性充血效果。Objective:To research the proper occlusion stress and time which result to the post-occlusion reactive hyperaemia(PORH)in patients with diabetes satisfyingly.Method:Twenty-eight patients of type 2 diabetes were studied on three consecutive days,we blocked the upper limb blood flow with sphygmomanometer cuff,the occlusion pressure and time were 20 mmHg above systolic blood pressure /2 min,30 mmHg above systolic blood pressure/3 min,and 40 mmHg above systolic blood pressure/4 min.Releasing the pressure suddenly result to PORH.Skin blood flux were measured before,during and after occlusion using Laser Doppler flowmetry(LDF).The minimum cutaneous microflow(PUmin),maxim cutaneous microflow(PUmax)and PUmax-PUmin were measured.Results:There were no statistical differences in PUmin among different occlusion states.In forearm,as the strss and time of occlusion increase,the reactive hyperemia flux which can be expressed by PUmax and PUmax-PUmin increased(40.39±15.45,36.16±15.56 in 40 mmHg/4 min,40.46±17.72,36.04±16.97 in 30 mmHg/3 min,28.27±15.48,23.70±15.72 in 20 mmHg/2 min).The former two were markedly higher than the latter.Conclusion:30 mmHg above systolic blood pressure/3 min can result to satisfying PORH in patients with diabetes.

关 键 词：2型糖尿病 反应性充血 患者皮肤 初步比较 压力 血管舒张功能障碍 激光多普勒血流仪 阻断持续时间 

分 类 号：R587.1[医药卫生—内分泌] R542.2[医药卫生—内科学]