Hemodynamic Study of Foot in Diabetic Patient Using Portable Doppler Machine. |
Lee, Il Yung , Rah, Ueon Woo , Moon, Hae Won , Yim, Shin Young , Chang, Ji Chan , Yang, Jung In |
Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Korea. |
간이 도플러 검사기를 사용한 당뇨 환자의 족부 혈역학적 검사 |
이일영, 나은우, 문혜원, 임신영, 장지찬, 양정인 |
아주대학교 의과대학 재활의학교실 |
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Abstract |
The importance of neuropathy in the pathogenesis of foot lesions has been well recognized in diabetes. Blood flow in ischemic limbs has been extensively investigated but the circulation of limbs affected by peripheral neuropathy has received little attention. Some studies on blood flow in peripheral neuropathy have shown a remarkable increase in resting flow, transcutaneous venous oxygen tension, and vascularity, along with loss of the spontaneous variations which occur normally with sympathetic activity of the foot in patients with diabetes. The aim of present study is to find out the effects of somatic and autonomic nervous function in early change of blood flow of foot in diabetic patients. We have studied fifty-one patients of non-insulin-dependent(type II) diabetes with no history of hypertension or diabetic foot ulcers. The evidence of neuropathy was screened by nerve conduction studies and sympathetic skin response of both lower extremities. Blood flow of dorsalis pedis and posterior tibial arteries was measured by portable doppler machine and presented as pressure index (ankle-to-arm systolic pressure ratio). The patients with sympathetic dysfunction showed significant decrease in pressure index compared to normal control and diabetic patients with normal sympathetic function, suggesting that changes of the blood flow occur in diabetic patients with sympathetic dysfunction. |
Key Words:
Diabetic foot, Blood flow, Peripheral neuropathy, Sympathetic dysfunction, Doppler |
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