Evaluation of Lower Limb Circulation by Non-Invasive Tests in Patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM) Who Developed Arteriosclerosis Obliterans (ASO)

摘要

Association with arteriosclerosis obliterans (ASO) has become a recent problem in treatment or keeping quality of life of patients with non insulin dependent diabetes mellitus (NIDDM). We performed two kinds of non-invasive tests such as transcutaneous oximetry (TcPO_2) and laser Doppler flowmetry of NIDDM patients who developed ASO and evaluated the usefulness of the methods for peripheral vasular flow examination. The subjects consisted of 27 NIDDM patients with ASO (Fontaine I, 14 and Fontaine II, 13), 16 NIDDM patients without ASO, and 12 non-diabetic healthy control. Averaged ages of these three groups were 69.6, 64.7, and 66.5 years respectively. TcPO_2, and laser Doppler flowmetry as non-invasive tests were performed in lower limb before, during, and after treadmill walking load. TcPO2 levels were significantly lower in Fontaine II ASO group than in control before the walking load and the TcPO_2 levels of Fontaine II ASO group was lower after the walking load. The recovery time of the TcPO_2 was also longer in Fontaine II ASO group than in other groups. There was no difference of laser Doppler flowmetry levels before the walking load in three groups. Fontaine II ASO group had only lower laser Doppler flowmetry level after the walking load. These results showed that TcPo_2 was affected by leg ischemia and laser Doppler flowmetry was by other factors such as neuropahy in leg. It was demonstrated that TcPO_2 and laser Doppler flowmetry as non-invasive evaluations in conjunction with treadmill walking load are useful in evaluation of peripheral vascular flow of leg in NIDDM patients.