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间歇性手臂缺血会引起对侧上肢血管扩张。

Intermittent arm ischemia induces vasodilatation of the contralateral upper limb.

机构信息

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

出版信息

J Physiol Sci. 2011 Nov;61(6):507-13. doi: 10.1007/s12576-011-0172-9. Epub 2011 Sep 8.

Abstract

Intermittent arm ischemia before percutaneous coronary intervention induces remote ischemic preconditioning (RIPC) and attenuates myocardial injury in patients with myocardial infarction. Several studies have shown that intermittent arm ischemia increases coronary flow and is related to autonomic nerve system. The aim of this study was to determine whether intermittent arm ischemia induces vasodilatation of other arteries and to assess changes in the autonomic nerve system during intermittent arm ischemia in humans. We measured change in the right brachial artery diameter during intermittent left arm ischemia through three cycles of 5-min inflation (200 mmHg) and 5-min deflation of a blood-pressure cuff using a 10-MHz linear array transducer probe in 20 healthy volunteers. We simultaneously performed power spectral analysis of heart rate. Ischemia-reperfusion of the left arm significantly dilated the right brachial artery time-dependently, resulting in a 3.2 ± 0.4% increase after the 3rd cycle. In the power spectral analysis of heart rate, the high-frequency domain (HF), which is a marker of parasympathetic activity, was significantly higher after the 3rd cycle of ischemia-reperfusion than baseline HF (P = 0.02). Intermittent arm ischemia was accompanied by vasodilatation of another artery and enhancement of parasympathetic activity. Those effects may play an important role in the mechanism of RIPC.

摘要

经皮冠状动脉介入治疗前间歇性手臂缺血可诱导远程缺血预处理(RIPC),减轻心肌梗死患者的心肌损伤。几项研究表明,间歇性手臂缺血可增加冠状动脉血流量,并与自主神经系统有关。本研究旨在确定间歇性手臂缺血是否会引起其他动脉的血管扩张,并评估人类间歇性手臂缺血期间自主神经系统的变化。我们通过使用 10MHz 线性阵列探头在 20 名健康志愿者中进行三次左手臂 5 分钟充气(200mmHg)和 5 分钟放气的循环,测量右肱动脉直径在间歇性左手臂缺血期间的变化。我们同时进行心率的功率谱分析。左手臂的缺血-再灌注明显地使右肱动脉随时间扩张,导致第三次循环后增加了 3.2±0.4%。在心率的功率谱分析中,高频域(HF),是副交感活动的标志物,在缺血-再灌注的第三次循环后明显高于基线 HF(P=0.02)。间歇性手臂缺血伴随着另一个动脉的血管扩张和副交感活动的增强。这些影响可能在 RIPC 的机制中起重要作用。

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