Drummond P D, Finch P M
Psychology Section, Murdoch University, Australia.
Brain. 1989 Oct;112 ( Pt 5):1351-8. doi: 10.1093/brain/112.5.1351.
Facial temperature and amplitude of capillary pulsations from the forehead and cheeks were measured shortly before and after pharmacological blockade of the stellate ganglion in 9 patients with reflex sympathetic dystrophy of an upper limb, and in 1 other patient with erythromelalgia of all four limbs. Patients were then heated to determine the effect of sympathetic blockade on mediation of thermoregulatory facial flushing. Release of vasoconstrictor tone following stellate ganglion blockade was invariably followed by an increase in orbital and cheek temperature, and by similar but less consistent increases in temperature of the forehead, lips and chin. The amplitude of capillary pulsations recorded from the forehead and cheeks also increased on the side of stellate ganglion blockade. Flushing of the forehead and cheek on the sympathetically intact side during body heating far outweighed the extent of flushing after release of vasoconstrictor tone. The thermoregulatory response was prevented by sympathetic blockade, indicating that an active sympathetic vasodilator pathway had been interrupted. In contrast, the temperature of the orbit during body heating was not influenced by sympathetic blockade. Asymmetry of forehead temperature was detected before sympathetic blockade in 8 of 9 patients with reflex sympathetic dystrophy, suggesting that autonomic disturbances in this condition may influence cervical sympathetic outflow. The results indicate that sympathetic vasodilator fibres passing through the stellate ganglion mediate thermoregulatory facial flushing, and that release of vasoconstrictor tone has only a minor influence on this response in most areas of the face.
在9例上肢反射性交感神经营养不良患者及另1例四肢红斑性肢痛症患者中，于星状神经节药物阻断前后不久测量了面部温度以及前额和脸颊的毛细血管搏动幅度。然后对患者进行加热，以确定交感神经阻断对体温调节性面部潮红介导作用的影响。星状神经节阻断后血管收缩张力的释放总是伴随着眼眶和脸颊温度的升高，前额、嘴唇和下巴温度也有类似但不太一致的升高。在星状神经节阻断侧，从前额和脸颊记录到的毛细血管搏动幅度也增加。身体加热期间，交感神经未受损一侧的前额和脸颊潮红程度远超过血管收缩张力释放后的潮红程度。交感神经阻断可阻止体温调节反应，表明活跃的交感神经血管舒张途径已被中断。相比之下，身体加热期间眼眶温度不受交感神经阻断的影响。9例反射性交感神经营养不良患者中有8例在交感神经阻断前检测到前额温度不对称，提示这种情况下的自主神经紊乱可能影响颈交感神经输出。结果表明，通过星状神经节的交感神经血管舒张纤维介导体温调节性面部潮红，并且血管收缩张力的释放在面部大多数区域对这种反应的影响较小。
