Belcaro G V, Grimaldi R, Guidi G
Microcirculation Laboratory, G. D'Annunzio University, Chieti, Italy.
Angiology. 1990 Jul;41(7):533-40. doi: 10.1177/000331979004100705.
The VSC (vacuum suction chamber) device, a new system to evaluate local capillary permeability, was used with laser Doppler flowmetry to study variations of permeability and of the microcirculation in 10 normal subjects; in 22 patients with moderate, superficial venous hypertension; and in 12 patients with postphlebitic limbs and severe venous hypertension. All these patients had distal (ankle and foot edema) in the evening. After a first assessment these subjects were studied again after two weeks without treatment and after two weeks' treatment with total triterpenic fraction of centella asiatica (TTFCA), tablets, 60 mg, tid. The VSC produces a wheal on the skin of the perimalleolar region that disappears (in average) in less than sixty minutes in normal subjects. The disappearance time (DT) is greater in conditions of increased capillary filtration and permeability. The three groups of subjects (normal and those with superficial and severe venous hypertension) had significantly different, increasing disappearance time of the wheals at the first observation. There were no significant changes after two weeks' observation, but after 2 weeks' treatment with TTFCA, there was a significant decrease of DT both in limbs with superficial and with deep venous incompetence. The improvement (decrease) of the abnormally increased capillary permeability was associated with a significant improvement of the microcirculation and symptoms (studied by an analogue scale line). In conclusion this study showed a combined improvement of the microcirculation and capillary permeability after treatment with TTFCA and the possibility of using the VSC to evaluate the effects of drugs (or other treatment) on local capillary permeability in patients with venous hypertension.
采用一种用于评估局部毛细血管通透性的新系统——真空吸引室(VSC)装置,结合激光多普勒血流仪,对10名正常受试者、22名中度浅表性静脉高压患者以及12名静脉炎后肢体伴严重静脉高压患者的通透性和微循环变化进行了研究。所有这些患者傍晚时均有远端(踝部和足部)水肿。在首次评估后,这些受试者在未经治疗两周后以及在服用积雪草总三萜部分(TTFCA)片剂(60毫克,每日三次)治疗两周后再次接受研究。VSC在踝周区域皮肤产生一个风团,在正常受试者中(平均)不到60分钟就会消失。在毛细血管滤过和通透性增加的情况下,消失时间(DT)会更长。三组受试者(正常受试者以及浅表性和严重性静脉高压患者)在首次观察时风团的消失时间显著不同且逐渐增加。两周观察后无显著变化,但在使用TTFCA治疗两周后,浅表性和深静脉功能不全肢体的DT均显著降低。毛细血管通透性异常增加的改善(降低)与微循环和症状(通过模拟量表线研究)的显著改善相关。总之,本研究表明,TTFCA治疗后微循环和毛细血管通透性联合改善,并且VSC有可能用于评估药物(或其他治疗)对静脉高压患者局部毛细血管通透性的影响。