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急性心肌梗死患者皮下组织血流的局部调节

Local regulation of blood flow in subcutaneous tissue in patients with acute myocardial infarction.

作者信息

Skagen K, Henriksen O, Amtorp O, Fog-Møller F, Lam H

出版信息

Clin Sci (Lond). 1981 Feb;60(2):157-64. doi: 10.1042/cs0600157.

DOI:10.1042/cs0600157
PMID:7237930
Abstract
  1. Local regulation of subcutaneous blood flow in the forearm was studied in the acute phase of myocardial infarction. Blood flow was measured by the local 133Xe-washout technique. 2. Plasma concentrations of noradrenaline and adrenaline were increased on day 1, suggesting an increase in sympathetic neuronal activity, but gradually returned to normal thereafter. 3. Subcutaneous blood flow on day 1 was far below normal (38%) and steadily increased to reach normal at day 7 after coronary occlusion. The sympathetic vasoconstrictor activity that caused the initial reduction in flow could be blocked by proximal nervous blockade, increasing the subcutaneous blood flow by 130, 63 and 14% on days 1, 3 and 7 respectively after coronary occlusion. A normal response to decrease in arterial perfusion pressure was observed, suggesting that intrinsic vascular reactions responsible for autoregulation of blood flow were not affected by the increase in sympathetic vasoconstrictor activity. The vasoconstrictor response to increase in venous transmural pressure could not be demonstrated on day 1 after coronary occlusion but gradually reappeared during the following days. 4. Abolition of the vasoconstrictor response is most likely to be due to a centrally elicited increase in sympathetic activity, as a normal vasoconstrictor response was obtained after proximal nervous blockade. Thus the local sympathetic reflex mechanism underlying the vasoconstrictor response appears to be suppressed by a centrally elicited increase in sympathetic discharge rate.
摘要
  1. 在心肌梗死急性期,对前臂皮下血流的局部调节进行了研究。采用局部¹³³氙洗脱技术测量血流。2. 去甲肾上腺素和肾上腺素的血浆浓度在第1天升高,提示交感神经活动增强,但此后逐渐恢复正常。3. 第1天的皮下血流远低于正常水平(38%),并在冠状动脉闭塞后第7天稳步增加至正常水平。导致血流最初减少的交感缩血管活动可被近端神经阻滞阻断,冠状动脉闭塞后第1天、第3天和第7天皮下血流分别增加130%、63%和14%。观察到对动脉灌注压降低的正常反应,提示负责血流自动调节的内在血管反应不受交感缩血管活动增加的影响。冠状动脉闭塞后第1天未显示出对静脉跨壁压升高的缩血管反应,但在随后几天逐渐重新出现。4. 缩血管反应的消失最可能是由于中枢引起的交感神经活动增加,因为近端神经阻滞后获得了正常的缩血管反应。因此,缩血管反应背后的局部交感反射机制似乎被中枢引起的交感放电率增加所抑制。

相似文献

1
Local regulation of blood flow in subcutaneous tissue in patients with acute myocardial infarction.急性心肌梗死患者皮下组织血流的局部调节
Clin Sci (Lond). 1981 Feb;60(2):157-64. doi: 10.1042/cs0600157.
2
Effect of head-up tilt on subcutaneous blood flow during the course of acute myocardial infarction.急性心肌梗死病程中头高位倾斜对皮下血流的影响。
Clin Sci (Lond). 1981 Feb;60(2):213-6. doi: 10.1042/cs0600213.
3
Sympathetic reflex control of subcutaneous blood flow in patients with congestive heart failure.
Clin Sci (Lond). 1986 May;70(5):513-22. doi: 10.1042/cs0700513.
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Control of skeletal muscle blood flow during postural changes in acute myocardial infarction.急性心肌梗死姿势改变期间骨骼肌血流的控制
Clin Sci (Lond). 1983 Oct;65(4):441-4. doi: 10.1042/cs0650441.
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Effect of lower body negative pressure upon local regulation of blood flow in human subcutaneous tissue.
Acta Physiol Scand. 1981 Feb;111(2):113-20. doi: 10.1111/j.1748-1716.1981.tb06713.x.
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Effect of locally applied subatmospheric pressure on subcutaneous blood flow during the course of acute myocardial infarction.
Clin Sci (Lond). 1982 Feb;62(2):243-5. doi: 10.1042/cs0620243.
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Local regulation of blood flow in subcutaneous tissue in generalized scleroderma.系统性硬化症中皮下组织血流的局部调节
J Invest Dermatol. 1977 May;68(5):318-21. doi: 10.1111/1523-1747.ep12494588.
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Sympathetic reflex control of skeletal muscle blood flow in patients with congestive heart failure: evidence for beta-adrenergic circulatory control.充血性心力衰竭患者骨骼肌血流的交感反射控制:β-肾上腺素能循环控制的证据
Circulation. 1986 Nov;74(5):929-38. doi: 10.1161/01.cir.74.5.929.
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Acta Physiol Scand. 1982 Jan;114(1):31-5. doi: 10.1111/j.1748-1716.1982.tb06948.x.
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Contribution of local blood flow regulation mechanisms during head-up tilt in human subcutaneous tissue.
Acta Physiol Scand. 1982 Dec;116(4):331-4. doi: 10.1111/j.1748-1716.1982.tb07150.x.

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