重度の下肢イシュケミアの患者で,毛細血管の徴募と足の依存性に対する痛み緩和
D T Ubbink1, M J Jacobs, D W Slaaf
1Department of Surgery, Academic Hospital Maastricht, The Netherlands.
Circulation
|January 1, 1992
まとめ
重度の足のイシュケミアの患者は,足が垂れ下がっているときに痛みを軽減することがあります. この研究では,毛細血管の徴募が示され,血管収縮が妨げられることはなく,進行した下肢イシュケミアのこの現象を説明しています.
科学分野:
- 血管生物学 血管生物学
- 微循環の研究 マイクロ循環の研究
- イシュケミア研究 イシュケミア研究
背景:
- 逆説的に,下肢の重度のイシュケミアは,足に依存した痛み緩和を引き起こす可能性があります.
- 足の依存は通常,動脈血管収縮を誘発する.
- 下肢のイシュケミアの皮膚の微循環を調査することは極めて重要です.
研究 の 目的:
- 足の依存性中に下肢の重度のイシュケミアの痛み緩和のパラドックスを明らかにするために.
- 下肢のイシュケミアにおける皮膚の微循環の役割を調査する.
- 栄養レベルでの姿勢性血管圧縮メカニズムを評価する.
主な方法:
- ネイルフォールド毛細血管ビデオ顕微鏡を用いた.
- 赤血球に浸透した毛細血管の密度,直径,速度を評価した.
- 下肢イシュケミアの75人の患者と12人の対照群で,座った姿勢と横になった姿勢を比較した.
主要な成果:
- 座っている状態では毛細血管の密度が著しく増加し,特に重度のイシュケミアの場合 (4.5倍増加).
- 毛細血管の perfusion は,軽度のイシュケミアでは座っている状態で低いが,重度のイシュケミアではわずかに高い.
- 重度のイシュケミアの痛み緩和は,座っている状態で,より高い毛細血管密度,必ずしもより高い perfusion と相関しています.
結論:
- 動脈動脈静脈静脈圧縮機構は,重度の下肢イシュケミアで障害があります.
- 毛細血管の徴募,動脈血管収縮の不調は,重度の缺血における足の依存性の好みを説明する可能性がある.
- 発見は,下肢の進行したイシュケミアの補償メカニズムを示唆しています.
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