Thomas P R, Nash G B, Dormandy J A
Department of Surgery, St. James's Hospital, London.
Br Med J (Clin Res Ed). 1988 Jun 18;296(6638):1693-5. doi: 10.1136/bmj.296.6638.1693.
The mechanism by which chronic venous insufficiency and venous hypertension are associated with ulceration of the legs is not yet understood. To investigate this mechanism further accumulation of white cells in the dependent legs of normal volunteers, patients awaiting surgery for simple varicose veins, and patients with chronic venous insufficiency was studied. About 24% fewer white cells than in normal subjects left the dependent foot of patients with venous hypertension, and this trapping of white cells, was reversed when the foot was raised; similar changes were not observed in normal subjects or patients with varicose veins. The trophic skin changes typically seen in patients with venous hypertension may be aggravated by damage caused by the repeated accumulation of white cells in the microcirculation.
慢性静脉功能不全和静脉高压与腿部溃疡相关的机制尚不清楚。为了进一步研究这一机制，对正常志愿者、等待单纯性静脉曲张手术的患者以及慢性静脉功能不全患者下垂腿部白细胞的积聚情况进行了研究。静脉高压患者下垂足部离开的白细胞比正常受试者少约24%，当足部抬高时，白细胞的这种滞留现象会逆转；正常受试者或静脉曲张患者未观察到类似变化。微循环中白细胞反复积聚造成的损伤可能会加重静脉高压患者典型的营养性皮肤改变。
