Itzchak Y, Silberberg A, Adar R, Deutsch V
Yale J Biol Med. 1977 Jul-Aug;50(4):375-81.
A method is presented for an evaluation of the hemodynamic significance of a stenotic lesion in the arterial tree.Twenty-three patients were examined with arteriosclerosis obliterans and intermittent claudication of the same severity. Flow velocity data obtained by angiodensitometry and viscosity values calculated from the hematocrit were inserted into the Poiseuille's flow formula to obtain the pressure drop across a stenotic lesion in the left external iliac artery. By the same way, the pressure gradient was calculated in 33 "normal" subjects.The normal pressure gradient along the external iliac artery varied between 23 to 110 dynes/cm(2) (52 ± 24 dynes/cm(2) for mean and S.d), and the normal resistance to flow was 6.08 ± 4.1 dyne sec/cm(5)).Stenotic lesions of similar dimensions gave widely varying pressure drops (114-4,736 dynes/cm(2)) (mean and S.d 1,309 ± 1,224 dynes/cm(2)) indicating a difference in the hemodynamic significance of the various lesions. These values were significantly different (p(t) < 0.001) from the normal values. The resistance across these stenotic lesions ranged between 21 to 768 dyne sec/cm(5) (196 ± 192 dyne sec/cm(5)) for the mean and S.d and this was significantly different from the normal group; p(t) < 0.001.Direct measurement of blood viscosity coupled with angiocinedensitometry at rest and after forced vasodilatation should provide an accurate means of determining the relative significance of a stenotic lesion and distal vessel disease in a given patient on blood flow to the leg.
本文提出了一种评估动脉树中狭窄病变血流动力学意义的方法。对23例患有相同严重程度的动脉硬化闭塞症和间歇性跛行的患者进行了检查。通过血管密度测定法获得的流速数据和根据血细胞比容计算出的粘度值被代入泊肃叶流动公式，以获得左髂外动脉狭窄病变两端的压降。同样地，对33名“正常”受试者计算了压力梯度。沿髂外动脉的正常压力梯度在23至110达因/平方厘米之间变化（平均值±标准差为52±24达因/平方厘米），正常血流阻力为6.08±4.1达因·秒/立方厘米。尺寸相似的狭窄病变产生的压降差异很大（114 - 4736达因/平方厘米）（平均值±标准差为1309±1224达因/平方厘米），表明不同病变的血流动力学意义存在差异。这些值与正常值有显著差异（t检验p < 0.001）。这些狭窄病变的阻力在21至768达因·秒/立方厘米之间（平均值±标准差为196±192达因·秒/立方厘米），与正常组有显著差异；t检验p < 0.001。在静息状态和强制血管扩张后，直接测量血液粘度并结合血管密度测定法，应能为确定特定患者中狭窄病变和远端血管疾病对腿部血流的相对意义提供一种准确的方法。
