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首页> 外文期刊>European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery >Peripheral sympathetic autoregulation in arterial calf inflow enhancement with intermittent pneumatic compression.
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Peripheral sympathetic autoregulation in arterial calf inflow enhancement with intermittent pneumatic compression.

机译：间歇性气动压缩促进小腿血管流入的周围交感自律调节。

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摘要

BACKGROUND: Peroperative mortality, graft failure and balloon angioplasty limitations mitigate against active intervention for claudication. With the exception of exercise programmes, conservative treatments yield limited results. Intermittent pneumatic compression of the foot (IPC(foot)) used daily for over 3 months enhances significantly the walking ability and pressure indices of stable claudicants; this is attributable to the significant calf inflow enhancement with IPC(foot); however, the physiologic mechanisms involved are only partially understood. Aims by comparing the effects of IPC(foot)and postural alteration on calf inflow haemodynamics, this study examines the role of peripheral sympathetic autoregulation, which controls homeostasis in lower limb vessels when posture changes, in the enhancement of calf inflow with IPC(foot)in healthy subjects and claudicants. MATERIAL AND METHODS: forty-one limbs of healthy subjects (n =34; Group I) and 48 limbs of stable claudicants (Fontaine II) (n =42; Group II) were studied. The volume flow (Q), pulsatility index (PI), mean (mV), peak systolic (PSV) and end diastolic (EDV) velocities were measured in the popliteal artery using duplex ultrasound in: the horizontal position, and on sitting with or without IPC(foot). RESULTS: in Group II: median Q, mV, PSV and EDV increased by 61%, 53%, 29% and 51% respectively, and PI decreased by 20% as posture changed from sitting to horizontal; with IPC(foot)median Q, mV, PSV and EDV increased by 70%, 58%, 22% and 75% respectively, and PI decreased by 26% (all p < 0.001). In Group I: median Q, mV, PSV and EDV increased by 125%, 115%, 51% and 38% respectively and PI decreased by 30% as posture changed from sitting to horizontal; with IPC(foot)median Q, mV, PSV and EDV increased by 119%, 153%, 23% and 46%, respectively, and PI decreased by 50% (all p < 0.001). The effects of IPC(foot)and postural alteration (from sitting to horizontal) did not differ haemodynamically (p > 0.1) in both groups. Q on lying was similar in Groups I and II. On sitting Q was higher in Group II [p =0.027 (95% CI 1.7, 27 ml/min)]. CONCLUSIONS: the striking similarity in the haemodynamic effects of IPC(foot)and postural alteration in the popliteal artery strongly suggests that the leg inflow enhancement with IPC(foot)is mediated by a transient suspension of peripheral sympathetic autoregulation. In addition to their role as clinical markers of PVD severity, the autoregulatory reflexes of peripheral circulation appear to have functions with significant clinical implications in the management of patients with leg inflow impairment. Copyright 2001 Harcourt Publishers Limited.
机译：背景：围手术期死亡率，移植失败和球囊血管成形术的局限性减轻了积极的c行干预。除运动计划外，保守治疗的效果有限。每天使用3个月以上的脚部间歇性气压（IPC（foot））可以显着提高稳定螯合剂的行走能力和压力指数;这是由于IPC（足部）显着增加了小腿的流入量;然而，所涉及的生理机制仅被部分理解。通过比较IPC（足）和姿势改变对小腿流入血流动力学的影响，本研究探讨了外周交感自律调节在姿势改变时控制下肢血管稳态的作用在IPC（足）增强小腿流入中的作用在健康的对象和笼统的人中。材料与方法：研究了四十一名健康受试者的肢体（n = 34; I组）和48名稳定螯合剂的肢体（Fontaine II）（n = 42; II组）。使用双重超声在the动脉中测量the动脉的体积流量（Q），搏动指数（PI），平均值（mV），收缩期峰值（PSV）和舒张末期（EDV）速度，测量方法为：没有IPC（英尺）。结果：在第二组：由于坐姿从水平改为水平，中位Q，mV，PSV和EDV分别增加了61％，53％，29％和51％，PI减少了20％。 IPC（足）中值Q，mV，PSV和EDV分别增加70％，58％，22％和75％，PI减少26％（所有p <0.001）。在第一组中，由于坐姿从水平改为水平，中位Q，mV，PSV和EDV分别增加了125％，115％，51％和38％，PI下降了30％。 IPC（足）中值Q，mV，PSV和EDV分别增加119％，153％，23％和46％，PI减少50％（所有p <0.001）。两组的IPC（足）和姿势改变（从坐到水平）的影响在血流动力学上没有差异（p> 0.1）。第一和第二组中关于撒谎的问题类似。坐着时，第二组的Q值较高[p = 0.027（95％CI 1.7，27 ml / min）。结论：IPC（足）的血液动力学效应与the动脉的姿势改变具有惊人的相似性，强烈暗示IPC（足）的腿部流入增强是由周围交感性自律调节的暂时性暂停介导的。除了作为PVD严重程度的临床标志物的作用外，外周循环的自动调节反射在腿部流入障碍患者的治疗中似乎具有重要的临床意义。版权所有2001 Harcourt Publishers Limited。

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