Author/Editor		Mlačak, Blaž; Žnidaršič, Franc; Bošnjak, Željko; Zujović, Edina; Ivka, Branimir
Title		Ugotavljanje pretočnih motenj v mikrocirkulaciji pri sladkornih bolnikih z lasersko-doplerskim merilnikom pretokov
Translated title		Evaluation of blood flow disturbances in diabetic patients by laser Doppler flowmetry
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 3
Publication year		2003
Volume		str. 153-6
Language		slo
Abstract		Background. The aim of this study was to investigate patients with non-insulin dependent diabetes by laser Doppler flowmetry in order to asses changes in the peripheral flow regulation during hemodynamics tests as evidence of impaired auto-regulation of the microcirculation. Methods. 2 groups of subjects were incorporated in the study. The first group included 20 patients with diabetes without electromyographical signs of neuropathy and without peripheral arterial occlusive disease while the second (control) group included 20 healthy subjects. Microcirculation investigations were carried out at rest and after hemodynamics tests. Blood flow was measured using a laser Doppler flowmetry. Changes in the flow minus the "biological zero" value were measured after 3 minutes of artificial arterial occlusion, after deep inspiration and by experimental venous hypertension (40 and 70 mm Hg) which was used to provoke venoarteriolar reflex. Results. Resting flow was significantly higher in diabetic patients compared to the healthy subjects (p < 0.01). The vasoconstrictor response to deep inspiration and experimental venous hypertension, cuff pressure 40 mm Hg, was significantly impaired in diabetic patients as compared to the healthy subjects (p < 0. 001 vs. p < 0. 01). The maximal hyperemia after artificial arterial occlusion was significantly reduced in diabetic patients in comparison with the healthy controls (p < 0.01). Conclusions. Laser Doppler flowmetry provides a non-invasive technique for evaluating microcirculating disturbances at a relatively stage in diabetes, long before the initial clinical presentation of peripheral arterial occlusive disease or neuropathy.
Summary		Izhodišča. Cilj raziskave je bil pregledati bolnike z diabetesom tipa 2 in s hemodinamskimi testi ugotoviti motnje avtonomnega uravnavanja poteka. Metode. Raziskali smo dve skupini preiskovancev. Prva je zajela 20 bolnikov z diabetesom brez elektromiografskih znakov avtonomne nevropatije, kot tudi brez periferne arterijske okluzivne bolezni in druga (kontrolna) 20 zdravih oseb. Pretoke v mikrocirkulaciji smo merili z lasersko-doplerskim merilnikompretokov v mirovanju in po hemodinamskih testih. Spremembe pretoka, zmanjšane za vrednosti "biološke ničle", smo registrirali po 3-minutnem arterijskem zažemu, po globokem vdihu in pri eksperimentalni venski hipertenziji (40 in 70 mm Hg), s katero smo izzvali venoarteriolni rejleks (VAR). Rezultati. Pretok v mirovanju v koži stopala diabetikov je bil pomembno večji v primerjavi s skupino zdravih preiskovancev (p < 0, 01). Globok vdih in venski zažem (tlak v manšeti 40 mm Hg) sta pri diabetikih povzročila pomembno manjše zmanjšanje pretoka (p < 0,001 oziroma p < 0,01) v primerjavi z zdravimi preiskovanci. Reaktivna hiperemija po arterijskem zažemu je bila pri diabetikih pomembno manjša v primerjavi s kontrolno skupino (p < 0,01). Zaključki. Z lasersko-doplerskim merilnikom pretokov lahko ugotovimo motnje pretoka v mikrocirkulaciji pred pojavom kliničnih znakov periferne arterijske okluzivne bolezni ali nevropatije.
Descriptors		DIABETES MELLITUS, NON-INSULIN-DEPENDENT DIABETIC ANGIOPATHIES LASER-DOPPLER FLOWMETRY BLOOD FLOW VELOCITY FOOT MICROCIRCULATION