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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 50, 2004, No. 11, p. 836 - 841 |
Assessment of Changes in Peripheral Microcirculation
in Type I Diabetics with Laser Doppler Flowmetry Hofírek I.1, Sochor O.1, Olšovský J.2 1I. interní kardio-angiologická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jiří Vítovec, CSc. 2II. interní klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Miroslav Souček, CSc. |
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Summary: Goal: To make out a methodology and assessment of peripheral microcirculation with laser Doppler
flowmetry (LDF) in patients with type I diabetes mellitus and to compare their results to
findings in healthy control people using frequency analyses. Methodology: A group of 32 patients
suffering from type I diabetes on an average for 14 years (group A) has been examined. The
patients suffered from a basic angiology disorder in arteries of lower extremities. Peripheral
circulation in lower extremities has been examined via laser Doppler flowmetry. The same tests
have been done in a group of 40 healthy people (group B). Results: Basic evaluation revealed no
statistical differences between groups A and B at rest (T0). Significant differences showed up
during vasodilation test (T2). Intensity of perfusion in group A was 37 ± 23 arbitrary perfusion
units (PU) compared to 81 ± 43 PU in group B (p < 0.001). During perfusion following ischemisation
(T1) levels of blood circulation in groups A and B were 71 ± 39 PU compared to 121 ± 89 PU (p <
0.018). During frequency analyses the intensity of slow vasomotion (SV) in group A was already
generally lower at rest (T0) 0.46 ± 0.42 PU compared to 1.12 ± 0.62 PU (p < 0.011) in group B.
During the reperfusion phase following ischemisation (T1) intensity of SV was 1.8 ± 0.78 PU
compared to 2.82 ± 1.58 (p < 0.17). Following vasodilation test (T2) perfusion was 0.79 ± 0.65 PU
compared to 1.86 ± 1.31 (p < 0.009). In areas of fast vasomotion (FV; frequency 0.210 - 0.420 Hz)
there were significant differences between group A and B at rest (T0) and during vasodilation test
(T2). At rest 0.08 ± 0.02 PU compared to 0.19 ± 0.05 PU (p < 0.006). During vasodilation test 0.14 ±
0.03 PU compared to 0.28 ± 0.11 PU (p < 0.004). Conclusion: This study presents an original examination
protocol and findings. Significant differences were identified in peripheral circulation of
patients suffering from solely type I diabetes mellitus and control people. So called spontaneous
venous reactivity (vasomotion) was in type I diabetics significantly lower already at rest and
especially in reaction to vasodilation stimulus. The differences can't be still clearly explained but
there is a suspicion they are a result of an impaired endotelial and autonomous function in type I diabetes mellitus. The method of frequency analyses of LDF records enables to give precision to
peripheral blood circulation evaluation. It could be used to detect early changes in blood circulation
as early as at rest.
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