Morgan R H, Psaila J V, Stone J, Carolan G, Woodcock J P
Department of Vascular Surgery, University of Wales College of Medicine, Cardiff, UK.
J Biomed Eng. 1991 May;13(3):244-8. doi: 10.1016/0141-5425(91)90135-t.
Regulatory peripheral vasoconstriction occurs in response to adoption of the erect posture. Mildly ischaemic limbs are thought to exhibit near normal responses, but patients with rest pain show increases in blood flow on limb dependency. Previous methods of limb blood flow quantification (xenon clearance and venous occlusion plethysmography) have inherent difficulties when applied in these situations. We studied orthostatic responses in 12 normal subjects (aged 22-74 years (median 52) and 16 patients (aged 21-83 (median 48) with mild and severe peripheral vascular disease, using a duplex flowmeter system. In the normal subjects changes in the 60s mean, common femoral artery volume flow values were as follows (ml min-1 (1 SD]: 77 (83), -78 (116) and -190 (136), for elevation, dependency, and standing respectively. For claudicants (n = 7) the values were 18 (37), -112 (123) and -216 (103) respectively. In rest pain patients (n = 9) the responses were reversed, being -252 (124), 131 (89) and 184 (85) respectively. Significant differences were apparent between elevation, dependency and standing flows in each of the three groups (P less than 0.0001). Normal subject and claudicant responses on elevation and dependency differed significantly (P less than 0.0001 and 0.03 respectively). On standing, the responses were similarly significantly different. The rest pain group displayed characteristically different responses compared with both normal subjects and claudicants for each postural change (P less than 0.0001 in all cases). Duplex ultrasound volume flowmetry is non-invasive and offers an excellent method of quantifying physiological changes.
调节性外周血管收缩是对采取直立姿势的反应。轻度缺血的肢体被认为表现出接近正常的反应，但静息痛患者在肢体下垂时血流量会增加。以前的肢体血流量量化方法（氙清除法和静脉阻塞体积描记法）在应用于这些情况时存在固有困难。我们使用双功血流仪系统研究了12名正常受试者（年龄22 - 74岁（中位数52岁））和16名患有轻度和重度外周血管疾病的患者（年龄21 - 83岁（中位数48岁））的直立反应。在正常受试者中，60秒平均股总动脉体积流量值如下（毫升/分钟（1个标准差））：抬高、下垂和站立时分别为77（83）、 - 78（116）和 - 190（136）。对于间歇性跛行患者（n = 7），相应的值分别为18（37）、 - 112（123）和 - 216（103）。在静息痛患者（n = 9）中，反应则相反，分别为 - 252（124）、131（89）和184（85）。三组中抬高、下垂和站立时的血流量之间均存在明显差异（P < 0.0001）。正常受试者和间歇性跛行患者在抬高和下垂时的反应有显著差异（分别为P < 0.0001和0.03）。站立时，反应同样有显著差异。与正常受试者和间歇性跛行患者相比，静息痛组在每种姿势变化时均表现出明显不同的反应（在所有情况下P < 0.0001）。双功超声体积血流测量是非侵入性的，是量化生理变化的极佳方法。
