Davison Jennifer L, Short Daniel S, Wilson Thad E
Dept. of Biomedical Science, Southwest Missouri State University and Southwest School of Nurse Anesthesia, Saint John's Regional Medical Center, Springfield, MO, USA.
Clin Auton Res. 2004 Dec;14(6):385-90. doi: 10.1007/s10286-004-0223-x.
The cutaneous venoarteriolar response (CVAR) is a local non-adrenergic vasoconstrictor reflex that is engaged via increases in local transmural pressure. The purpose of this study was to determine if local temperature alters the vasoconstrictor ability of the CVAR. Twelve (5 male, 7 female) subjects performed a CVAR maneuver at local temperatures of 30+/-1, 34, 38, and 42 degrees C. CVAR was also engaged after vasodilation via intradermal perfusion of sodium nitroprusside or the attenuation of local heating-induced vasodilation via intradermal perfusion of N(G)-nitro-L: -arginine methyl ester (L: -NAME) in five subjects (2 male, 3 female). CVAR was elicited by rapid cuff inflation to 45mmHg proximal to two dorsal forearm sites for 2 min in both protocols. Local heating caused a progressive increase in skin blood flow (8+/-1, 18+/-4, 43+/-11, and 78+/-2% maximal skin blood flow for 30+/-1, 34, 38, and 42 degrees C, respectively). Engagement of the CVAR decreased skin blood flow by 53+/-2, 57+/-3, and 51+/-4%, for 30+/-1, 34, and 38 degrees C, respectively. In contrast, local heating to 42 degrees C significantly attenuated the CVAR (16+/-11 %). Local administration of sodium nitroprusside during neutral temperature and L: -NAME during local heating also significantly attenuated the vasoconstrictor response of the CVAR by 27+/-8 and 38+/-4%, respectively. These data indicate that CVAR is attenuated at high (42 degrees C) local skin temperatures and that this attenuation is likely due to an effect of both local heating-induced vasodilation and a direct temperature effect.
皮肤静脉小动脉反应(CVAR)是一种局部非肾上腺素能血管收缩反射,通过局部跨壁压力升高而激活。本研究的目的是确定局部温度是否会改变CVAR的血管收缩能力。12名受试者(5名男性,7名女性)在30±1、34、38和42摄氏度的局部温度下进行CVAR操作。在5名受试者(2名男性,3名女性)中,通过皮内灌注硝普钠进行血管舒张后或通过皮内灌注N(G)-硝基-L-精氨酸甲酯(L-NAME)减弱局部加热诱导的血管舒张后,也激活了CVAR。在两种方案中,通过快速将袖带充气至两个前臂背侧部位近端45mmHg并持续2分钟来引发CVAR。局部加热导致皮肤血流量逐渐增加(30±1、34、38和42摄氏度时分别为最大皮肤血流量的8±1、18±4、43±11和78±2%)。CVAR的激活使30±1、34和38摄氏度时的皮肤血流量分别减少53±2、57±3和51±4%。相比之下,局部加热至42摄氏度显著减弱了CVAR(16±11%)。在中性温度下局部给予硝普钠以及在局部加热时给予L-NAME也分别显著减弱了CVAR的血管收缩反应,分别为27±8%和38±4%。这些数据表明,CVAR在局部皮肤温度较高(42摄氏度)时减弱,这种减弱可能是由于局部加热诱导的血管舒张和直接温度效应共同作用的结果。