Pain and Autonomics - Integrative Research (PAIR), Department of Psychiatry and Psychotherapy, University Hospital, Jena 07743, Germany.
Drug Alcohol Depend. 2011 Dec 1;119(1-2):113-22. doi: 10.1016/j.drugalcdep.2011.06.002. Epub 2011 Jun 29.
Endothelial dysfunction (EF) is a central phenomenon in a variety of conditions associated with increased cardiovascular morbidity. Here, we investigated EF during acute alcohol withdrawal syndrome before and 24h after medication. We aimed to analyze microcirculation, applying the post-occlusive reactive hyperemia (PORH) test and spectral analysis of skin vasomotion as markers of EF. Additionally, we explored whether segmentation of spectral analysis data may disclose more detailed information on dynamic blood flow behavior.
We investigated 30 unmedicated patients during acute alcohol withdrawal syndrome and matched controls. Patients were reinvestigated after 24h when half of them had been treated with clomethiazole. Capillary blood flow was assessed on the right forearm after compression of the brachial artery. Parameters of PORH such as time to peak (TP), slope and PORH indices were calculated. Spectral analysis was performed in order to study five different frequency bands. Withdrawal symptoms were quantified by means of the alcohol withdrawal scale (AW scale).
We observed a blunted hyperemic response in patients after occlusion of the brachial artery indicated by significantly increased TP and decreased PORH indices. In contrast, vasomotion as investigated by spectral analysis was not altered. Segmentation analysis revealed some alterations in the cardiac band at rest, and indicated differences between treated and untreated patients after 24h.
Our results suggest peripheral endothelial dysfunction in patients during acute alcohol withdrawal. No major influence of treatment was observed. Future studies need to address the relation of EF to cardiac morbidity during alcohol withdrawal.
内皮功能障碍（EF）是多种与心血管发病率增加相关的疾病的中心现象。在这里，我们研究了药物治疗前后急性酒精戒断综合征期间的 EF。我们旨在通过后闭塞性充血反应（PORH）试验和皮肤血管舒缩的频谱分析来分析微血管功能，以此作为 EF 的标志物。此外，我们还探讨了频谱分析数据的分段是否可以揭示关于动态血流行为的更详细信息。
我们研究了 30 名未经药物治疗的急性酒精戒断综合征患者，并与对照组相匹配。24 小时后，其中一半患者接受了氯美噻唑治疗，我们对这些患者进行了再调查。通过压迫肱动脉来评估右前臂的毛细血管血流。计算 PORH 的时间至峰值（TP）、斜率和 PORH 指数等参数。为了研究五个不同的频带，进行了频谱分析。采用酒精戒断量表（AW 量表）来量化戒断症状。
我们观察到患者在肱动脉闭塞后的充血反应减弱，表现为 TP 显著增加和 PORH 指数降低。相比之下，通过频谱分析研究的血管舒缩运动并未改变。分段分析显示，在静息状态下，心脏频带存在一些改变，并且在 24 小时后，治疗组和未治疗组之间存在差异。
我们的研究结果表明，急性酒精戒断期间患者存在外周内皮功能障碍。未观察到治疗的主要影响。未来的研究需要探讨 EF 与酒精戒断期间心脏发病率之间的关系。
