糖尿病患者における足背静脈血酸素分圧の上昇　　糖尿病性神経障害の一徴候としての足の動静脈シャント量の増加

DOI 被引用文献1件

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タイトル別名
  • Elevation of blood gas oxygen content in the foot vein of diabetic patients.
  • Increased Arterio-venous Shunt as a Sign of Diabetic Neuropathy
  • 糖尿病性神経障害の一徴候としての足の動静脈シャント量の増加

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In order to evaluate the existence of arteriovenous (A-V) shunting in the feet of diabetic patients, the partial pressure of oxygen was measured in the dorsal foot vein (PvO2) and in the artery (PaO2). Diabetic patients were divided into four groups; 9 patients without any complications, 6 with neuropathy but without vascular complications, 14 with neuropathy and microangiopathy and 6 with foot ulcers. None of these patients had signs of arterial stenosis of the lower extremities. There was no difference between the mean PvO2 levels in normal controls (40.3±7.8mmHg, mean ± SD) and in diabetic patients without complications (38.6±8.6mmHg). The mean PvO2 levels were 55.8±8.3mmHg in diabetic patients with neuropathy only., 56.6±10.7mmHg in patients with neuropathy and microangiopathy and 57.5±8.0mmHg in patients with foot ulcers. These values were similar to each other, but significatly higher than PvO2 values in control subjects and diabetic patients without complications (p<0.001). To evaluate the effects of neurological disturbances on A-V shunt, diabetic patients without microangiopathy were selected, and the relationship of PvO2 with nerve conduction velocities was analyzed. There were significant inverse correlations of PvO2 with the nerve conduction velocities of the lower extremities (NCV). When there was a significant difference in the NCVs of the right and left legs, PvO2 was always higher in the leg with slower NCV.<BR>In randomly selected patients, there were significant inverse correlations of PvO2 with the variations in heart rate during deep breathing (ΔHR).<BR>By the use of se ratio of PvO2 to PaO2 (PvO2/PaO2) instead of PvO2, better correlation with NCVs and ΔHR were demonstrated. While there was some overlap of PvO2 values between diabetic patients with and without complications, virtually no overlap was observed in the PVO2/PaO2 ratios between groups with and without complications.<BR>These results indicate that the elevation of PvO2 and PvO2/PaO2 correlates with diabetic neuropathy rather than with microangiopathy and suggest that the increase in A-V shunt in the foot is a common finding of diabetic neuropathy. The ratio of PvO2/PaO2 seems better than PvO2 as an index of A-V shunt.

収録刊行物

  • 糖尿病

    糖尿病 27 (10), 1059-1065, 1984

    一般社団法人 日本糖尿病学会

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