Grote Ludger, Zou Ding, Kraiczi Holger, Hedner Jan
Sleep Laboratory, Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Respir Physiol Neurobiol. 2003 Jul 16;136(2-3):141-52. doi: 10.1016/s1569-9048(03)00090-9.
We investigated a non-invasive measurement for changes in finger blood flow during wakefulness and sleep. Changes in finger blood flow, reflected by pulse wave amplitude (PWA) derived from finger plethysmography, were compared with changes in forearm vascular flow assessed by venous occlusion plethysmography after intra-arterial infusion of norepinephrine (NE), phentolamine, and isoproterenol (n=15, 15, 14 subjects, respectively). Moreover, PWA was assessed during obstructive breathing during sleep (n=8 patients). Vasoconstriction in the finger (PWA) was stronger than that obtained in the forearm vascular bed in the higher NE dose range both without (ANOVA, P=0.002) and with concomitant phentolamine-induced alpha-receptor blockade (P=0.02). Isoproterenol increased forearm blood flow but did not induce flow changes detectable by the finger plethysmographic technique (P<0.001). PWA was significantly reduced during arousal from obstructive sleep apnea (-37.5+/-16.1%, P=0.002, n=6 patients), suggesting vasoconstriction in the digital vascular bed. PWA derived from finger plethysmography allows continuous, non-invasive measurement of changes in finger blood flow during wakefulness and sleep. However, as may be expected from the anatomical and functional differences between the finger and forearm vascular beds and demonstrated by the lack of response to beta(2)-receptor stimulation, PWA does not mimic forearm vascular flow characteristics. Thus, finger plethysmography may be a useful complement to current vascular research techniques, in particular to monitor sympathetic influences on skin blood flow in the finger.
我们研究了一种用于测量清醒和睡眠期间手指血流变化的非侵入性方法。通过手指体积描记法得出的脉搏波振幅（PWA）所反映的手指血流变化，与在动脉内注射去甲肾上腺素（NE）、酚妥拉明和异丙肾上腺素后，通过静脉阻塞体积描记法评估的前臂血管血流变化进行了比较（分别为n = 15、15、14名受试者）。此外，还对睡眠期间阻塞性呼吸时的PWA进行了评估（n = 8例患者）。在较高NE剂量范围内，无论有无（方差分析，P = 0.002）酚妥拉明诱导的α受体阻断作用（P = 0.02），手指（PWA）的血管收缩都比前臂血管床更强。异丙肾上腺素增加了前臂血流，但未引起手指体积描记技术可检测到的血流变化（P < 0.001）。在阻塞性睡眠呼吸暂停唤醒期间，PWA显著降低（-37.5±16.1%，P = 0.002，n = 6例患者），提示手指血管床存在血管收缩。手指体积描记法得出的PWA能够对手指在清醒和睡眠期间的血流变化进行连续、非侵入性测量。然而，鉴于手指和前臂血管床在解剖和功能上的差异，以及对β2受体刺激缺乏反应所证明的情况，PWA并不能模拟前臂血管血流特征。因此，手指体积描记法可能是当前血管研究技术的一种有用补充，特别是用于监测交感神经对手指皮肤血流的影响。
