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闭塞性动脉硬化症患者肱动脉局部顺应性及盐水输注情况

Regional compliance of brachial artery and saline infusion in patients with arteriosclerosis obliterans.

作者信息

Levenson J A, Simon A C, Maarek B E, Gitelman R J, Fiessinger J N, Safar M E

出版信息

Arteriosclerosis. 1985 Jan-Feb;5(1):80-7. doi: 10.1161/01.atv.5.1.80.

Abstract

Simultaneous brachial artery pressure and blood flow measurements were made in 15 patients with arteriosclerosis of the lower limbs (AOLL) and in controls of the same age and sex. Blood flow was evaluated by a pulsed Doppler device with a double-transducer probe. From analysis of the pressure-flow curves during diastole, regional arterial compliance (RAC) was determined by using as a model of the forearm arterial tree a system of tubes, each with a storage capacity, in series with the arteriolar resistance vessels. In AOLL patients, RAC was significantly reduced (102 +/- 13 vs 173 +/- 14.10(-4) ml/mm Hg, p less than 0.01), and systolic pressure was significantly increased. After saline infusion, systolic pressure continued to increase and arterial compliance, to decrease; brachial blood flow did not change. Study of the baroreflex sensitivity in AOLL patients under basal conditions indicated that a higher pulse pressure was required to obtain the same heart rate as in the controls. The study provided evidence that in AOLL patients: 1) compliance was reduced in the brachial artery (a regional circulation with no clinical evidence of arterial occlusion); 2) an increase in systolic pressure resulted from the decreased arterial compliance; and 3) saline infusion exaggerated the observed reduction in arterial compliance and increase in systolic pressure.

摘要

对15例下肢动脉硬化(AOLL)患者以及年龄和性别匹配的对照组同时进行肱动脉压力和血流测量。采用带有双换能器探头的脉冲多普勒装置评估血流。通过分析舒张期压力 - 血流曲线,将一套具有储存容量的串联细动脉阻力血管的管道系统作为前臂动脉树模型,测定局部动脉顺应性(RAC)。在AOLL患者中,RAC显著降低(102±13对比173±14.10⁻⁴ ml/mm Hg,p<0.01),收缩压显著升高。输注生理盐水后,收缩压持续升高,动脉顺应性持续降低;肱动脉血流无变化。对基础状态下AOLL患者压力反射敏感性的研究表明,与对照组相比,需要更高的脉压才能获得相同的心率。该研究提供的证据表明,在AOLL患者中:1)肱动脉(无动脉闭塞临床证据的局部循环)顺应性降低;2)动脉顺应性降低导致收缩压升高;3)输注生理盐水加剧了观察到的动脉顺应性降低和收缩压升高。

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