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[酒石酸艾芬地尔在下肢闭塞性动脉病中的作用。使用近端血流和远端经皮氧分压的联合研究]

[Action of ifenprodil tartrate in obliterative arteriopathies of the lower limbs. Combined studies using proximal blood flow and distal transcutaneous oxygen pressure].

作者信息

Costes Y, Pruniaux T, Roullier M, Bourgeois F, Flicoteaux H, Neidhardt A, Barale F

出版信息

J Mal Vasc. 1986;11(3):242-7.

PMID:3772255
Abstract

A simultaneous analysis of both the variations of the flow in the stenosis artery and the distal PO2, was carried out during an injection of an alpha-blocker: the Tartrate d'Ifenprodil, on twenty-five patients afflicted with occlusive disease of the lower limbs requiring surgery. The measurements were taken under general anaesthesia, before any surgical operation, the hemodynamic and ventilatory balance being monitored by radial manometry and arterial gas analysis. We observe an increase of proximal arterial flow and at the same time an improvement of the distal TcPO2. Moreover, the variations of microcirculation flow measured by TcPO2 are correlated with proximal flow variations, this relation: delta TcPO2 = K delta Q + A is more true in the first and the second stages of Fontaine. With the same (Tartrate d'Ifenprodil) posology, the distal benefit measured by transcutaneous oximetry is less important in advanced stages compared with other stages (everything else being equal). The transcutaneous measurement of the distal oxygen pressure, allows an objective view of microcirculatory improvement obtained by a vasoactive substance (ifenprodil tartrate) considering the specific nature of each patient arteriopathy.

摘要

在对25名患有下肢闭塞性疾病需要手术的患者注射α-阻滞剂(酒石酸艾芬地尔)期间,同时分析了狭窄动脉中的血流变化和远端氧分压。测量在全身麻醉下进行,在任何外科手术之前,通过桡动脉测压和动脉血气分析监测血流动力学和通气平衡。我们观察到近端动脉血流增加,同时远端经皮氧分压(TcPO2)有所改善。此外,通过TcPO2测量的微循环血流变化与近端血流变化相关,这种关系:δTcPO2 = KδQ + A在Fontaine第一和第二阶段更为明显。在相同剂量(酒石酸艾芬地尔)下,与其他阶段相比,在晚期通过经皮血氧测定法测量的远端获益较小(其他条件相同)。考虑到每位患者动脉病变的具体性质,通过经皮测量远端氧压,可以客观地观察到血管活性物质(酒石酸艾芬地尔)所带来的微循环改善情况。

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