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[健康受试者腿部姿势性血管运动反射的评估]

[Evaluation of posturally-induced vasomotor reflexes of the leg in the healthy subject].

作者信息

Pistorius M A, Planchon B

机构信息

Service de Médecine Interne, Hôtel Dieu, Nantes.

出版信息

J Mal Vasc. 1994;19(2):126-31.

PMID:8077861
Abstract

The authors' aim was to assess, using a routinely usable methodology, the distal vasomotor reflexes induced by postural changes of the lower limbs in 36 healthy volunteers (18 women and 18 men, mean age: 22.3 years, range 19-26). These distal vasomotor changes were recorded on the great toe using mercury-strain-gauge plethysmography. In the first step, the authors have measured the veno-arterial reflex obtained by elective lowering of the leg, the subject lying strictly horizontally under standardized conditions. Secondly was assessed the distal vasomotor reflex due to orthostatism (seated position, legs hanging). Correlations between these postural reflexes and height, weight, sex, length of the lower limbs, femoral venous diameters assessed by echography were studied. The veno-arterial reflex obtained by elective verticalization of the leg (0.68 +/- 0.21) corresponds to a 32% mean decrease in the amplitude of the plethysmographic recording as compared to the initial amplitude in horizontal position. It is all the more marked as the subject is male and the leg is long, thus inducing a equivalent change of hydrostatic venous pressure during verticalization of this part of the limb. On the other hand, this adaptative reflex appears all the more intense as the basal vascular tone in horizontal position is low. Passing to orthostatism induces a distal vasoconstriction corresponding to a 51% mean decrease in the amplitude of the plethysmographic signal as compared to the initial basal amplitude. This general reflex, playing a part in the keeping of hemodynamic conditions when passing to orthostatism, appeared significantly correlated to the diameter of the common femoral vein when the subject is lying horizontally.

摘要

作者的目的是采用一种常规可用的方法,评估36名健康志愿者(18名女性和18名男性,平均年龄:22.3岁,范围19 - 26岁)下肢姿势变化所诱发的远端血管运动反射。这些远端血管运动变化通过汞应变片体积描记法记录在大脚趾上。第一步,作者测量了通过选择性降低腿部获得的静脉 - 动脉反射,受试者在标准化条件下严格水平躺卧。其次评估了由于直立姿势(坐姿,双腿下垂)引起的远端血管运动反射。研究了这些姿势反射与身高、体重、性别、下肢长度、通过超声检查评估的股静脉直径之间的相关性。通过选择性使腿部垂直获得的静脉 - 动脉反射(0.68±0.21)与体积描记记录的幅度相比,在水平位置时的初始幅度平均降低了32%。受试者为男性且腿部较长时,这种反射更为明显,因此在该部分肢体垂直时会引起相当的静水静脉压变化。另一方面,当水平位置的基础血管张力较低时,这种适应性反射显得更为强烈。转变为直立姿势会诱发远端血管收缩,与体积描记信号的幅度相比,与初始基础幅度相比平均降低了51%。这种一般反射在转变为直立姿势时对维持血液动力学状态起作用,当受试者水平躺卧时,它与股总静脉直径显著相关。

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