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随着静脉充血压力的小幅累积增加,人体小腿毛细血管前阻力会降低。

Human calf precapillary resistance decreases in response to small cumulative increases in venous congestion pressure.

作者信息

Gamble J, Christ F, Gartside I B

机构信息

Microcirculation Laboratory, Imperial College School of Medicine, Charing Cross Hospital, London, UK.

出版信息

J Physiol. 1998 Mar 1;507 ( Pt 2)(Pt 2):611-7. doi: 10.1111/j.1469-7793.1998.611bt.x.

DOI:10.1111/j.1469-7793.1998.611bt.x
PMID:9518718
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2230793/
Abstract
  1. We studied human lower limbs to test the hypothesis that the application of small cumulative venous congestion pressure steps is associated with a reduction in precapillary resistance. 2. Strain gauge plethysmography was performed on twenty-one young subjects (22.7 +/- 0.6 years). At each of the small cumulative pressure steps, limb blood flow was estimated from the initial slope of the volume response to transient (10 s duration) elevations of venous congestion pressure to 90 mmHg, after which the congestion pressure was returned to the previous value. The blood flow at each pressure was also expressed as a percentage of the initial control value. Peak tibial arterial blood flux was assessed, in four of the subjects, using colour duplex ultrasonography and the same congestion pressure protocol. 3. We used Darcy's Law to predict the limb arterial blood flow and blood flux at each venous congestion pressure, assuming that both mean arterial blood pressure and precapillary resistance remained constant. 4. The mean +/- S.E.M. control arterial blood flow at the lowest venous congestion pressure, 4.8 +/- 0.1 mmHg, was 2.77 +/- 0.18 ml min-1 (100 ml)-1. At the highest venous congestion pressure, 59.2 +/- 0.2 mmHg, arterial blood flow was 2.45 +/- 0.35 ml min-1 (100 ml)-1 (121.6 +/- 16.9% of the initial value). This did not differ significantly from the initial control value, but was significantly greater than the predicted value of 0.77 +/- 0.13 ml min-1 (100 ml)-1 (28.6 +/- 2.1% of the initial value) calculated assuming constant resistance and sustained mean arterial pressure. The tibial arterial peak blood flux at 58.3 mmHg venous congestion pressure was 102.2 +/- 2.3% of the control value, which was significantly greater than the predicted 17.2 +/- 1.3% of control, calculated for this pressure, assuming constant resistance and sustained mean arterial pressure. 5. Our data show that lower limb arterial blood flow is sustained when venous congestion pressure is raised using small cumulative steps, even at congestion pressures approaching mean arterial blood pressure. These data support the notion that precapillary resistance is influenced by signals generated at the microvascular and post microvascular levels and transmitted via the endothelium.
摘要
  1. 我们研究了人类下肢,以检验以下假设:施加小幅度累积静脉充血压力步骤与毛细血管前阻力降低相关。2. 对21名年轻受试者(22.7±0.6岁)进行了应变片体积描记法检查。在每个小幅度累积压力步骤中,根据静脉充血压力短暂升高(持续10秒)至90 mmHg时体积反应的初始斜率来估计肢体血流量,之后充血压力恢复到先前值。每个压力下的血流量也表示为初始对照值的百分比。在4名受试者中,使用彩色双功超声和相同的充血压力方案评估了胫动脉峰值血流。3. 我们使用达西定律来预测每个静脉充血压力下的肢体动脉血流量和血流,假设平均动脉血压和毛细血管前阻力保持恒定。4. 在最低静脉充血压力4.8±0.1 mmHg时,平均±标准误对照动脉血流量为2.77±0.18 ml·min⁻¹(100 ml)⁻¹。在最高静脉充血压力59.2±0.2 mmHg时,动脉血流量为2.45±0.35 ml·min⁻¹(100 ml)⁻¹(初始值的121.6±16.9%)。这与初始对照值无显著差异,但显著大于假设阻力恒定和平均动脉压持续时计算出的预测值0.77±0.13 ml·min⁻¹(100 ml)⁻¹(初始值的28.6±2.1%)。在58.3 mmHg静脉充血压力下,胫动脉峰值血流为对照值的102.2±2.3%,这显著大于假设阻力恒定和平均动脉压持续时针对该压力计算出的预测对照值的17.2±1.3%。5. 我们的数据表明,当使用小幅度累积步骤升高静脉充血压力时,即使在充血压力接近平均动脉血压时,下肢动脉血流量仍能维持。这些数据支持以下观点:毛细血管前阻力受微血管和微血管后水平产生并通过内皮传递的信号影响。

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Relationship between venous pressure and tissue volume during venous congestion plethysmography in man.人体静脉充血体积描记术中静脉压与组织容积之间的关系
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The effect of passive tilting on microvascular parameters in the human calf: a strain gauge plethysmography study.被动倾斜对人体小腿微血管参数的影响:一项应变计体积描记法研究。
J Physiol. 1997 Jan 15;498 ( Pt 2)(Pt 2):541-52. doi: 10.1113/jphysiol.1997.sp021880.
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