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[闭塞性动脉病变时人类下肢血管的神经支配]

[Innervation of the blood vessels of the human lower extremities in occlusive arterial lesions].

作者信息

Medvedev V N

出版信息

Arkh Anat Gistol Embriol. 1984 Sep;87(9):27-33.

PMID:6508555
Abstract

In 63 patients suffering from an obliterating thromboangiitis and atherosclerosis the state of the efferent innervation of the shin and foot vessels has been studied. The material has been obtained during reconstructive surgical operations from various segments of the extremities and in the patients suffering from regional ischemic disorders of various degree. Moreover, adrenergic structures of the lumbar sympathetic ganglia have been investigated after sympathectomy performed. In the patients suffering from thromboangiitis, in the adventitial arterial tunic some foci are revealed containing single adrenergic neural fibers. Topography concerning localization of these foci is extremely asystematic. At atherosclerosis the innervational structures have character of a chronic exhaustion. In the sympathetic ganglia neurons, catecholamine-containing structures are revealed; they are seen as accumulations of norepinephrine granules. As demonstrates the comparison of the clinical and neurohistochemical data, in development of the obliterating thromboangiitis a sharp catecholamine deficiency and a pervent effect of the disturbed innervational connections on the vascular tunics play an essential role. At atherosclerosis the mechanism of the chronic exhaustion of the neuromediators belongs evidently, to the phenomenon of the "postmediatory stage" of the neural elements ontogenesis.

摘要

对63例患有闭塞性血栓性血管炎和动脉粥样硬化的患者,研究了小腿和足部血管传出神经支配的状态。材料取自肢体不同节段的重建性外科手术过程中,以及患有不同程度局部缺血性疾病的患者。此外,在进行交感神经切除术后,对腰交感神经节的肾上腺素能结构进行了研究。在患有血栓性血管炎的患者中,在外膜动脉层发现了一些含有单个肾上腺素能神经纤维的病灶。这些病灶定位的地形学极无系统性。在动脉粥样硬化时,神经支配结构具有慢性耗竭的特征。在交感神经节神经元中,发现了含儿茶酚胺的结构;它们表现为去甲肾上腺素颗粒的聚集。临床和神经组织化学数据的比较表明,在闭塞性血栓性血管炎的发展过程中,严重儿茶酚胺缺乏以及神经支配连接紊乱对血管壁的有害作用起着重要作用。在动脉粥样硬化时,神经介质慢性耗竭的机制显然属于神经元件个体发生“中介后阶段”的现象。

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