Schubert V, Fagrell B
Karolinska Institute, Department of Geriatric Medicine, Huddinge Hospital, Stockholm, Sweden.
Clin Physiol. 1991 Mar;11(2):169-82. doi: 10.1111/j.1475-097x.1991.tb00110.x.
The response of skin blood cell flux (SBF) to locally applied pressure was evaluated with the laser-Doppler technique in the areas of the sacrum and the gluteus maximus muscle of geriatric patients and healthy young and elderly subjects. The SBF over the sacrum stopped at a lower external skin pressure than over the gluteus muscle in all groups studied (P less than 0.05-0.001). The SBF at rest was lower among geriatric patients and over the sacrum, with men showing the lowest value (P less than 0.001). The initial slope of the SBF curve and the peak SBF during the post-occlusive reactive hyperaemia (PRH) were lower among geriatric patients compared to younger healthy subjects (P less than 0.05-0.01) over both areas studied. During the last part of the PRH response rhythmic oscillations started, known as vasomotion. The mean skin temperature at rest was higher over the sacrum (P less than 0.001) than over the gluteus area, but no difference was found between the groups. The temperature increase during the PRH was larger over the gluteus muscle (P less than 0.01) than over the sacrum area in the healthy subjects. Among the patients the temperature increase was larger over the gluteus only during the first half of the PRH, after which the temperature increased most over the sacrum. It is concluded that SBF and skin temperature show different responses in microvascular reactivity to external pressure in elderly vs. younger subjects and also between sexes. The described technique may be useful in clinical practice for predicting the risk of pressure sores in different areas and subjects.
采用激光多普勒技术，在老年患者以及健康青年和老年受试者的骶骨和臀大肌区域，评估皮肤血细胞通量（SBF）对局部施加压力的反应。在所有研究组中，骶骨部位的SBF在低于臀肌部位的外部皮肤压力时就停止了（P<0.05 - 0.001）。老年患者以及骶骨部位静息时的SBF较低，男性的值最低（P<0.001）。在研究的两个区域，与年轻健康受试者相比，老年患者在闭塞后反应性充血（PRH）期间的SBF曲线初始斜率和峰值SBF较低（P<0.05 - 0.01）。在PRH反应的最后阶段开始出现有节奏的振荡，即血管运动。静息时骶骨部位的平均皮肤温度高于臀肌区域（P<0.001），但各研究组之间未发现差异。在健康受试者中，PRH期间臀肌区域的温度升高幅度大于骶骨区域（P<小于0.01）。在患者中，仅在PRH的前半段，臀肌区域的温度升高幅度较大，之后骶骨区域的温度升高幅度最大。结论是，在老年与年轻受试者以及不同性别之间，SBF和皮肤温度在微血管对外界压力的反应中表现出不同。所描述的技术在临床实践中可能有助于预测不同区域和受试者发生压疮的风险。
