Liubchenko P N, Gorenkov R V
Ter Arkh. 2005;77(10):53-7.
To investigate a vasoregulating function of the endothelium of the upper limbs' major arteries in patients with vibration disease (VD); to determine VD role in pathogenesis of vascular disorders.
A total of 54 VD men free of cardiovascular disease (age 42.4 +/- 0.98 years) with mean occupational local vibration contact 19.4 +/- 1.12 years entered the study. Diameter of the brachial and radial arteries and hemodynamics in them were measured with triplex scanning of the vessels. Hemodynamics in smaller vessels was examined with dopplerography. A vasoregulating function of vascular endothelium was assessed with a postocclusion test with reactive hyperemia, cold and nitroglycerin tests on sites distant from the sites exposed to vibration and close to such sites.
Abnormal endothelium-dependent responses at distal parts of the radial artery as marked vasoconstriction in the phase of ischemia and in response to cold, inhibition of systolic and volume speed of blood flow in reactive hyperemia were found. The strongest changes were seen in finger hand arteries. No disturbances of endothelium-independent reactions in nitroglycerin test were seen.
Vascular disturbances in the action of local vibration on the workers' hands are explained not only by systemic impacts but also by local disorders of endothelial function of hand vessels.
研究振动病（VD）患者上肢主要动脉内皮的血管调节功能；确定VD在血管疾病发病机制中的作用。
共有54名无心血管疾病的VD男性（年龄42.4±0.98岁）参与研究，其平均职业性局部振动接触时间为19.4±1.12年。通过血管的三功扫描测量肱动脉和桡动脉的直径及其血流动力学。用多普勒超声检查较小血管的血流动力学。通过反应性充血后闭塞试验、远离和靠近振动暴露部位的冷试验和硝酸甘油试验评估血管内皮的血管调节功能。
在桡动脉远端发现内皮依赖性反应异常，表现为缺血期和对冷刺激时明显的血管收缩，反应性充血时收缩期和血流容积速度受到抑制。手指手部动脉变化最为明显。硝酸甘油试验中未发现内皮非依赖性反应紊乱。
局部振动对手部工人的作用导致的血管紊乱不仅是由全身影响引起的，还与手部血管内皮功能的局部紊乱有关。
