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微透析针创伤对人体皮肤血管反应的影响。

The effect of microdialysis needle trauma on cutaneous vascular responses in humans.

作者信息

Hodges Gary J, Chiu Caroline, Kosiba Wojciech A, Zhao Kun, Johnson John M

机构信息

Department of Physiology The University of Texas Health Science Center San Antonio, Texas, USA.

出版信息

J Appl Physiol (1985). 2009 Apr;106(4):1112-8. doi: 10.1152/japplphysiol.91508.2008. Epub 2009 Feb 5.

Abstract

Microdialysis enables in-depth mechanistic study of the cutaneous circulation in humans. However, whether the insertion or presence of the microdialysis fiber (MDF) affects the skin circulation or its responses is unknown. We tested whether the cutaneous vascular response to whole body heating (WBH) was affected by MDF or by pretreatment with ice (part 1) or local anesthesia (LA; part 2). Eleven subjects participated, 9 in part 1 and 8 in part 2 (5 participated in both). In both parts, four sites on the forearm were selected, providing untreated control, MDF only, ice or LA only, and combined MDF plus ice or LA. A tube-lined suit controlled whole body skin temperature, which was raised to approximately 38 degrees C for WBH. Skin sites were instrumented with laser-Doppler flow probes. Data were expressed as cutaneous vascular conductance (CVC). Baseline levels were not different among sites (P > 0.05). In part 1, the internal temperature for the onset of vasodilation was higher (P > 0.05) with MDF with or without ice pretreatment than at untreated control sites (control 36.6 +/- 0.1 degrees C, Ice 36.5 +/- 0.1, MDF 36.8 +/- 0.1 degrees C, and Ice+MDF 36.8 +/- 0.1 degrees C). Peak CVC during WBH was decreased (P < 0.05) by MDF (control 73 +/- 7 vs. MDF 59 +/- 6% of maximal CVC). Ice (73 +/- 6% of maximal CVC) or Ice+MDF (69 +/- 6% of maximal CVC) did not affect (P > 0.05) peak CVC compared with control. In part 2, the temperature threshold for the onset of vasodilation was increased by MDF with or without LA treatment and by LA alone (P < 0.05; control 36.6 +/- 0.1 degrees C, MDF 36.7 +/- 0.1 degrees C, LA 36.8 +/- 0.1 degrees C, and LA+MDF 36.8 +/- 0.1 degrees C). Peak CVC was decreased by MDF (control 69 +/- 6% of maximal CVC vs. MDF 58 +/- 8% of maximal CVC; P < 0.05). LA only (65 +/- 10% of maximal CVC) or MDF in the presence of LA (73 +/- 12% of maximal CVC) did not affect (P > 0.05) peak CVC compared with control. Thus LA or MDF increases the temperature threshold for the onset of vasodilation. MDF alone decreases the peak vasodilator response in CVC to WBH; however, this attenuation did not occur if ice or LA is used before MDF placement. Ice or LA alone do not affect the peak response in CVC to WBH. How those treatments prevent or reverse the effect of MDF placement is presently unclear.

摘要

微透析技术有助于对人体皮肤循环进行深入的机制研究。然而,微透析纤维(MDF)的插入或存在是否会影响皮肤循环或其反应尚不清楚。我们测试了全身加热(WBH)引起的皮肤血管反应是否受MDF影响,或者是否受冰敷预处理(第1部分)或局部麻醉(LA;第2部分)的影响。11名受试者参与了研究,9人参与第1部分,8人参与第2部分(5人同时参与两部分)。在两部分研究中,均在前臂选择了4个部位,分别为未处理的对照部位、仅放置MDF的部位、仅冰敷或仅局部麻醉的部位,以及同时放置MDF并进行冰敷或局部麻醉的部位。一套带管道的套装用于控制全身皮肤温度,在进行WBH时将其升高至约38摄氏度。皮肤部位用激光多普勒血流探头进行检测。数据以皮肤血管传导率(CVC)表示。各部位的基线水平无差异(P>0.05)。在第1部分中,无论有无冰敷预处理,放置MDF时血管舒张开始时的内部温度均高于未处理的对照部位(对照36.6±0.1摄氏度,冰敷36.5±0.1,MDF 36.8±0.1摄氏度,冰敷+MDF 36.8±0.1摄氏度;P>0.05)。WBH期间的CVC峰值因MDF而降低(对照为最大CVC的73±7%,MDF为59±6%;P<0.05)。与对照相比,冰敷(最大CVC的73±6%)或冰敷+MDF(最大CVC的69±6%)对CVC峰值无影响(P>0.05)。在第2部分中,无论有无LA处理,放置MDF以及单独使用LA均会使血管舒张开始时的温度阈值升高(P<0.05;对照36.6±0.1摄氏度,MDF 36.7±0.1摄氏度,LA 36.8±0.1摄氏度,LA+MDF 36.8±0.1摄氏度)。CVC峰值因MDF而降低(对照为最大CVC的69±6%,MDF为58±8%;P<0.05)。与对照相比,单独使用LA(最大CVC的65±10%)或在LA存在下放置MDF(最大CVC的73±12%)对CVC峰值无影响(P>0.05)。因此,LA或MDF会提高血管舒张开始时的温度阈值。单独使用MDF会降低CVC对WBH的血管舒张峰值反应;然而,如果在放置MDF之前使用冰敷或LA,则不会出现这种衰减。单独使用冰敷或LA不影响CVC对WBH的峰值反应。目前尚不清楚这些处理如何预防或逆转放置MDF的影响。

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