Scott H J, Cheatle T R, McMullin G M, Coleridge Smith P D, Scurr J H
Department of Surgical Studies, University College and Middlesex School of Medicine, Middlesex Hospital, London, UK.
Br J Surg. 1990 Aug;77(8):934-6. doi: 10.1002/bjs.1800770830.
Raised oxygen tension in the blood of varicose veins has led to arteriovenous communications being implicated in the pathogenesis of varicose veins. The aim of this study was to compare the oxygen tension of blood from varicose veins with that from normal legs, and to observe the effect of posture on these measurements. Twenty-six subjects (13 normal controls and 13 with uncomplicated varicose veins) had blood sampled from the long saphenous vein or a varicose vein near the ankle. Samples were taken after 30 min in the supine position and repeated after 30 min standing. Samples were also taken simultaneously from the arm. Transcutaneous oxygen measurements of the gaiter skin were performed continuously throughout the experiment. In the supine position, blood from varicose veins had a significantly higher oxygen tension (median = 6.09 kPa) than that from normal veins (median = 4.54 kPa) (P = 0.022). In all subjects, there was a higher oxygen tension in leg vein blood when lying (varicose vein median value = 6.09 kPa, control median value = 4.54 kPa) than while standing (varicose vein median value = 3.93 kPa, control median value = 3.74 kPa) (P less than 0.002, varicose vein group; P = 0.005, normal group). Changes in transcutaneous oxygen tension correlate poorly with changes in venous blood. It is concluded that the theory of arteriovenous anastomoses is only one among a number of possible explanations for the pathogenesis of varicose veins.
静脉曲张血液中氧分压升高导致动静脉交通支被认为与静脉曲张的发病机制有关。本研究的目的是比较静脉曲张血液与正常腿部血液的氧分压，并观察体位对这些测量结果的影响。26名受试者（13名正常对照者和13名单纯性静脉曲张患者）从大隐静脉或踝关节附近的曲张静脉采集血液样本。在仰卧位30分钟后采集样本，站立30分钟后重复采集。同时也从手臂采集样本。在整个实验过程中持续进行小腿皮肤的经皮氧测量。在仰卧位时，曲张静脉血液的氧分压（中位数 = 6.09 kPa）显著高于正常静脉血液（中位数 = 4.54 kPa）（P = 0.022）。在所有受试者中，腿部静脉血液在卧位时的氧分压更高（曲张静脉中位数 = 6.09 kPa，对照组中位数 = 4.54 kPa），高于站立时（曲张静脉中位数 = 3.93 kPa，对照组中位数 = 3.74 kPa）（曲张静脉组P < 0.002；正常组P = 0.005）。经皮氧分压的变化与静脉血变化的相关性较差。得出结论，动静脉吻合理论只是静脉曲张发病机制多种可能解释中的一种。
