Stücker Markus, Huntermann Christina, Bechara Falk Georges, Hoffmann Klaus, Altmeyer Peter
Department of Dermatology and Allergology, Ruhr-University Bochum, Germany.
Skin Res Technol. 2004 Aug;10(3):174-7. doi: 10.1111/j.1600-0846.2004.00064.x.
The capillary blood flow of the nailfold can be measured by means of modern non-invasive techniques like the videocapillary microscope in vivo. To quantify the capillary blood cell velocity, apart from the nailfold capillaries, we used a new technique, the so-called laser Doppler anemometry (LDA).
The present study investigated how far laser Doppler fluxmetry (LDF), transcutaneous partial pressure of oxygen (tcpO2), and LDA are capable of quantifying differences of cutaneous microcirculation between patients with leg ulcera and a healthy control group. The effects of intravenous prostaglandin E1 and pentoxifylline were also investigated.
Ten patients with venous leg ulcers and 10 patients with mixed venous/arterial ulcers were investigated with LDF, tcpO2, and LDA before and after injection of prostaglandin E1 and pentoxifylline. We measured the resting capillary blood cell velocity (rCBV), the maximum hyperemia, and the time to peak capillary blood cell velocity (tpCBV) during hyperemia after 4 min of suprasystolic occlusion and compared them with the results of a contol group of 20 patients.
Laser Doppler flow was increased in all patients during resting period, whereas the tcpO2 was significantly decreased. LDF did not show an extension of tpCBV during reactive hyperemia after suprasystolic occlusion compared to the control group (73.6+/-31.1 vs. 164.1+/-52.5 s, P=0.003). TcpO2 revealed significantly decreased tpCBV in patients with venous and mixed venous/arterial ulcers (90.1+/-61.7 vs. 162.7+/-65.5 s, P< or =0.0001). LDA showed no significant differences between patients and control group (P>0.8). After application of prostaglandin E1, LDA revealed a significant increase of erythrocyte velocity (0.5+/-0.18 to 0.74+/-0.28 mm/s [P=0,01]), whereas pentoxifylline had no significant effect. Capillary density increased significantly after application of prostaglandin E1 (5,1+/-2.7/mm2 to 8.9+/-3/mm2 [P=0.001]) and pentoxifylline (5.3+/- 1.8/mm2 to 8+/-2.1/mm2 [P=0.006]).
The LDA is an important additional investigation tool for cutaneous microcirculation.
甲襞的毛细血管血流可通过现代非侵入性技术在体内进行测量，如视频毛细血管显微镜。为了量化毛细血管血细胞速度，除了甲襞毛细血管外，我们使用了一种新技术，即所谓的激光多普勒血流仪（LDA）。
本研究调查了激光多普勒血流测量法（LDF）、经皮氧分压（tcpO2）和LDA在多大程度上能够量化腿部溃疡患者与健康对照组之间皮肤微循环的差异。还研究了静脉注射前列腺素E1和己酮可可碱的效果。
对10例静脉性腿部溃疡患者和10例静脉/动脉混合性溃疡患者在注射前列腺素E1和己酮可可碱前后进行LDF、tcpO2和LDA检查。我们测量了静息时的毛细血管血细胞速度（rCBV）、最大充血量以及收缩压以上闭塞4分钟后充血期间达到毛细血管血细胞速度峰值的时间（tpCBV），并将其与20例对照组患者的结果进行比较。
所有患者在静息期激光多普勒血流均增加，而tcpO2显著降低。与对照组相比，LDF在收缩压以上闭塞后的反应性充血期间未显示tpCBV延长（73.6±31.1秒对164.1±52.5秒，P = 0.003）。tcpO2显示静脉性和静脉/动脉混合性溃疡患者的tpCBV显著降低（90.1±61.7秒对162.7±65.5秒，P≤0.0001）。LDA显示患者与对照组之间无显著差异（P>0.8）。应用前列腺素E1后，LDA显示红细胞速度显著增加（0.5±0.18至0.74±0.28毫米/秒[P = 0.01]），而己酮可可碱无显著影响。应用前列腺素E1后毛细血管密度显著增加（5.1±2.7/平方毫米至8.9±3/平方毫米[P = 0.001]），应用己酮可可碱后也显著增加（5.3±1.8/平方毫米至8±2.1/平方毫米[P = 0.006]）。
LDA是皮肤微循环的一种重要的辅助检查工具。
