Rossi Marco, Carpi Angelo, Di Maria Cinzia, Galetta Fabio, Santoro Gino
University of Pisa,
Microvasc Res. 2006 Jul-Sep;72(1-2):34-41. doi: 10.1016/j.mvr.2006.04.001. Epub 2006 Jun 22.
The aim of this study was to investigate whether human essential arterial hypertension (EHT) is associated with modification of the skin blood flowmotion (SBF), which could be a sign of skin microcirculatory impairment. Forearm skin perfusion was measured by laser Doppler flowmetry (LDF) in conventional perfusion units (PU) before and after ischemia in 20 middle-age newly diagnosed EHT untreated patients, in 20 middle-age long standing EHT treated patients and in 30 age and sex matched healthy normotensive subjects (NS). Power spectral density (PSD) of SBF total spectrum (0.009-1.6 Hz), as well of five different frequency intervals (FI), each of them related to endothelial (0.009-0.02 Hz), sympathetic (0.02-0.06 Hz), myogenic (0.06-0.2 Hz), respiratory (0.2-0.6) or cardiac (0.6-1.6) activity, was also measured in PU(2)/Hz before and after ishemia, using Fourier analysis of LDF signal. The three studied groups did not differ in basal and post-ischemic skin perfusion or in basal SBF parameters considered. However, while a significant post-ischemic increase in PSD of total spectrum SBF (P < 0.001) and of its different FI, with the only exception of respiratory FI, was observed in NS, a significsnt post-ischemic increase in PSD was observed only for total spectrum (P < 0.01) and for endothelial FI (P < 0.001) in newly diagnosed EHT patients and only for myogenic FI (P < 0.05) in long standing EHT patients. These findings suggest that the mechanisms which mediate the post-ischemic increment of SBF are perturbed earlier in human EHT than the mechanisms which mediate the skin post-ischemic hyperaemia. The same findings also suggest that the impairment of the endothelial mechanism involved in SBF control occurs by the time in the course of EHT.
本研究的目的是调查人类原发性高血压（EHT）是否与皮肤血流运动（SBF）的改变有关，这可能是皮肤微循环受损的一个迹象。在20例新诊断的未经治疗的中年EHT患者、20例长期接受治疗的中年EHT患者以及30例年龄和性别匹配的健康血压正常受试者（NS）中，采用激光多普勒血流仪（LDF）在常规灌注单位（PU）下测量前臂皮肤灌注，测量在缺血前后进行。还使用LDF信号的傅里叶分析，在缺血前后以PU(2)/Hz为单位测量了SBF总频谱（0.009 - 1.6 Hz）以及五个不同频率区间（FI）的功率谱密度（PSD），每个频率区间分别与内皮（0.009 - 0.02 Hz）、交感神经（0.02 - 0.06 Hz）、肌源性（0.06 - 0.2 Hz）、呼吸（0.2 - 0.6）或心脏（0.6 - 1.6）活动相关。所研究的三组在基础和缺血后皮肤灌注或所考虑的基础SBF参数方面没有差异。然而，在NS中观察到缺血后总频谱SBF的PSD（P < 0.001）及其不同FI有显著增加，呼吸FI除外；在新诊断的EHT患者中，仅总频谱（P < 0.01）和内皮FI（P < 0.001）在缺血后PSD有显著增加；在长期EHT患者中，仅肌源性FI（P < 0.05）在缺血后PSD有显著增加。这些发现表明，在人类EHT中，介导缺血后SBF增加的机制比介导皮肤缺血后充血的机制更早受到干扰。相同的发现还表明，在EHT病程中，参与SBF控制的内皮机制的损害此时已经发生。
