在患有严重下肢缺血症的患者中,毛细血管招募和缓解腿部依赖的疼痛
D T Ubbink1, M J Jacobs, D W Slaaf
1Department of Surgery, Academic Hospital Maastricht, The Netherlands.
Circulation
|January 1, 1992
概括
严重的腿缺血患者可能会在腿部垂下时感到疼痛缓解. 这项研究表明毛细血管的招募,而不是干扰血管收缩,解释了这种现象在晚期下肢缺血.
科学领域:
- 血管生物学 血管生物学
- 微循环研究 微循环研究
- 缺血学研究 缺血学研究
背景情况:
- 矛盾的是,严重的下肢缺血可能会导致腿部依赖的疼痛缓解.
- 腿部依赖通常会诱导动脉血管收缩.
- 在下肢缺血中研究皮肤微循环是至关重要的.
研究的目的:
- 为了澄清在腿部依赖期间严重下肢缺血时缓解疼痛的悖论.
- 研究皮肤微循环在下肢缺血中的作用.
- 在营养水平上评估姿势血管收缩机制.
主要方法:
- 使用了指甲毛细血管视频显微镜.
- 评估红细胞透的毛细血管密度,直径和速度.
- 在75名患有下肢缺血症的患者和12名对照患者中,比较了躺着和坐着的位置.
主要成果:
- 坐姿时毛细血管密度显著增加,特别是在严重的缺血症 (增加4.5倍).
- 毛细血管输液在轻度缺血时在坐姿下较低,但在严重缺血时略高.
- 在严重缺血症的疼痛缓解与较高的毛细血管密度相关,不总是更高的输液,在坐姿.
结论:
- 在严重的下肢缺血症中,动脉静脉姿势血管收缩机制受损.
- 毛细血管招募,不扰乱动脉血管收缩,可能解释了在严重缺血中偏好腿部依赖.
- 研究结果表明,在晚期下肢缺血中存在补偿机制.
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