运动后糖尿病患者下肢经皮氧分压变化的趋势-东南大学学报医学版

运动后糖尿病患者下肢经皮氧分压变化的趋势

单位：东南大学附属中大医院内分泌科, 江苏南京 210009

分类号：R587.1

出版年·卷·期（页码）：2013·32·第六期（692-697）

摘要：

目的：研究运动对2型糖尿病患者下肢经皮氧分压（tcpO₂）的影响，以探索运动时的tcpO₂动态变化对糖尿病患者循环障碍的诊断价值。方法：用踩踏功率自行车运动干预方法观察了12例2型糖尿病患者（24条下肢）以及3名正常成人（6条下肢）腓肠肌tcpO₂的变化情况，同时检测静息状态下的踝肱比（ABI）和定量振动阈值（QST）。根据患者ABI水平将患者肢体分成>0.9而≤1.3亚组、0.7~0.9亚组和<0.7亚组3组，比较分析各组tcpO₂变化情况。结果：所有糖尿病患者的tcpO₂水平在运动过程中均出现下降趋势，而正常组则出现上升趋势。在静息状态下，tcpO₂运动前后的变化值与ABI呈线性相关，但与QST并无线性关系。在ABI>0.9而≤1.3亚组tcpO₂在运动早期出现轻度升高，但随即下降到基础水平；在ABI为0.7~0.9亚组，tcpO₂在运动初期即出现下降；在ABI<0.7亚组则出现快速下降。结论：在运动中测量tcpO₂水平有助于对糖尿病患者微循环储备功能的判断。

Objective: To study the influences of exercise on the trends of transcutaneous oxygen tension (tcpO₂) in lower limbs of patients with type 2 diabetes. Methods: Twelve diabetes (test group) and 3 healthy subjects (control group) performed on the recumbent cycle ergometre (CE) with fixed seat. The tcpO₂ was examined on the calf which represents local leg blood flow during exercise. Ankle brachial index (ABI) and quantitative sensory test (QST) of the lower limbs were measured at resting state. According to the levels of subject's ABI, the diabetes were sub grouped into three scales (>0.9 and ≤1.3, 0.7-0.9 and less 0.7). TcpO₂ changes amongst the group were compared with different groups. Results: Pattern of post-exercise tcpO₂ change was unique for each sub group of diabetes in comparison to control group (P<0.05). Resting ABI level showed linear association with net tcpO₂ change (r=0.493, P<0.05) and displayed no association with QST level. Changes of tcpO₂ in time following exercise revealed unique pattern for different sub group; exercise increased the basal tcpO₂ level soon after the exercise and maintained even after end of exercise in control group. Diabetes with ABI>0.9 and ≤1.3 group were marked with increase in tcpO₂ at the beginning and returned to initial level soon after the exercise. Exercise resulted in early decrease with compensatory increase in ABI 0.7-0.9 diabetes and declined sharply with no compensatory phase in ABI less 0.7 group. Conclusion: The tcpO₂ tested during the exercise can reveal the reserve function of the circulation of the limbs in patients with type 2 diabetes.

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