Mortimer P S, Simmonds R, Rezvani M, Robbins M, Hopewell J W, Ryan T J
Department of Dermatology, Slade Hospital, Oxford, U.K.
J Invest Dermatol. 1990 Dec;95(6):677-82. doi: 10.1111/1523-1747.ep12514347.
The measurement of skin lymph flow was investigated using an isotope clearance technique (ICT). Multiple lymph flow determinations were undertaken in the skin of anaesthetized large white pigs to test for reproducibility, ascertain the most suitable tracer, study the influence of injection dynamics, and observe the effect of massage as a stimulus to lymph flow. Blood clearance of tracer was also investigated. Results demonstrated that lymphatic clearance is a monoexponential function with good reproducibility under controlled laboratory conditions. 99mTc-colloid (TCK17 Cis) compared favorably with 131I-human serum albumin as a tracer and both performed better than colloid gold (198Au). Lymph flow was significantly faster in one pig than in the other. No difference existed between left and right sides or between caudal and rostral sites on each flank, but clearance was significantly slower in thigh than flank skin. Sub-epidermal injections cleared faster and more consistently than either deep or subcutaneous injections. Neither injection volume nor needle tract backflow of tracer influenced results, but local massage significantly enhanced clearance. Escape of 99mTc-colloid by the blood was negligible. These results indicate that skin lymph flow can be reliably measured when conditions are controlled. Extrinsic factors such as massage strongly influence lymph flow. Greater sensitivity in detecting degrees of lymphatic insufficiency may be achieved if a standardized stimulus to lymph flow is administered during isotope clearance measurement.
采用同位素清除技术（ICT）对皮肤淋巴流量进行了研究。在麻醉的大型白色猪的皮肤上进行了多次淋巴流量测定，以测试其可重复性，确定最合适的示踪剂，研究注射动力学的影响，并观察按摩作为淋巴流动刺激因素的效果。还对示踪剂的血液清除情况进行了研究。结果表明，在受控的实验室条件下，淋巴清除是一种具有良好可重复性的单指数函数。作为示踪剂，99mTc-胶体（TCK17 Cis）与131I-人血清白蛋白相比具有优势，两者都比胶体金（198Au）表现更好。一只猪的淋巴流动明显比另一只猪快。每侧的左侧和右侧之间或尾部和头部部位之间没有差异，但大腿处的清除明显比胁腹皮肤慢。表皮下注射比深部或皮下注射清除得更快且更一致。示踪剂的注射体积和针道回流均不影响结果，但局部按摩可显著增强清除效果。99mTc-胶体通过血液的逸出可忽略不计。这些结果表明，在条件受控时，皮肤淋巴流量可以可靠地测量。诸如按摩等外在因素会强烈影响淋巴流动。如果在同位素清除测量期间给予标准化的淋巴流动刺激，可能会在检测淋巴功能不全程度方面获得更高的灵敏度。
