糖尿病患者足部皮肤反应性充血在三种血流阻断压力下的变化  

Defference of Lower Limbs Skin Postocclusive Reactive Hyperemia on Three Occlusion Stress Conditions for Diabetes Patients

作　　者：沈英华[1] 傅汉菁[1] 赵静[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2期36-37,40,共3页Chinese Journal of Microcirculation

摘　　要：目的:探讨2型糖尿病患者足部皮肤微血管反应性充血在3种血流阻断压力下的变化。方法:对28例2型糖尿病患者右足相关部位施以三种持续压力阻断血流,分别为收缩压以上20mmHg/2min,30mmHg/3min,40mmHg/4min,减压后造成反应性充血(PORH)。用激光多普勒血流仪(LDF)连续检测内踝及足背皮肤微血流值,比较三种压力下皮肤微血流基值(PU0),最小血流值(PUmin),反应性充血最大值(PUmax)及最大储备量(PUmax-PUmin)、最大变化程度(PUmax-PU0)。结果:三种压力条件下的内踝和足背皮肤PU0、PUmin差异无统计学意义(P>0.05),PUmax、PUmax-PUmin、PUmax-PU0等指标在40mmHg/4min时明显大于20mmHg/2min,差异有非常显著性统计学意义(P<0.01)。结论:LDF检测PORH可用于糖尿病患者内皮依赖性舒张功能的判断,对足部施加收缩压以上40mmHg压力持续4min能获得较满意的临床检测结果。Objective:To discuss the relation between Occlusion stress pressure and time and lower limbs skin postocclusive reactive hyperemia for type 2 diabetes patients.Method:28 type 2 diabetes patients were performed with different level of stress on right lower limbs to occlude blood,and the strength for stress and lasting time were 20mmHg/2min,30mmHg/3min,40mmHg/4min above the systolic blood pressure respectively,Laser doppler flowmeter(LDF)was employed to continuously measure and record the skin blood perfusion curve on right malleolus medialis and instep.Comparison between basal cutannous microflow(PU0),stressed minimum cutaneous microflow(PUmin),and reactive maxim cutaneous microflow(PUmax),also functional reserve(PUmax-Pumin),and variable reserve(PUmax-PU0)were performed with three sets of stress occlusion conditions.Results:In case of three sets of stress conditions,there was no statistic significant difference between the right malleolus medialis in PU0,PUmin(P>0.05).PUmax,PUmax-Pumin,PUmax-PU0 in accordance with 40 mmHg/4 min was much higher than those value with 20 mmHg/2 min.For set of value with 30mmHg/3min,no significant statistic difference was found for both two sets mentioned above(P>0.05).Similar result was obtained in determination of instep.Conclusion:LDF can be employed to determine the blood perfusion continuously,further to verify the flow mediated dilation for type 2 diabetes patients according to the status of postocclusion reactive hyperaemia.The reactive is significant when occlude blood together with application of 40mmHg above systolic blood pressure stress on lower limber lasting for 4 min.

关 键 词：反应性充血 皮肤血流 糖尿病患 血流阻断 压力 激光多普勒血流仪 Reactive DOPPLER 

分 类 号：R542.2[医药卫生—心血管疾病] R247.3[医药卫生—内科学]