Skin vasodilator response to local heating in human chronic spinal cord injury
Skin vasodilator response to local heating in human chronic spinal cord injury
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DOI：
10.1111/j.1468-1331.2004.00889.x
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发表时间：
2004-12-01
影响因子：
5.1
通讯作者：
Mathias, CJ
中科院分区：
文献类型：
--
作者：
Nicotra, A;Asahina, M;Mathias, CJ
局部加热引起皮肤血流量（SkBF）增加，包括初始峰值（轴突反射介导），随后是短暂的最低点和二次上升至平台。本研究的目的是探讨热引起的血管舒张是否检测脊髓损伤（SCI）患者的交感神经血管功能障碍和损伤的完整性。研究了12名（7名完全和5名不完全; C4-L4级）SCI患者和9名健康受试者作为对照。将局部加热皮肤的恒温激光多普勒探头放置在手和足的背上。在基线和血管舒张第一个峰值（SkBF（max））时通过激光多普勒血流仪测量SkBF。另一方面，三组之间基线时的SkBF和SkBF（max）相似。在足部，三组之间基线时的SkBF相似，但完全性SCI患者的SkBF（max）与对照组相比显著降低（P < 0.01）。总之，热引起的轴突反射血管舒张减少在足，低于病变水平，在完全SCI。这项测试，评估局部交感神经血管功能障碍，可能是一个有用的非侵入性技术，以检测SCI后自主神经中断的完整性。
Local heating evokes an increase in skin blood flow (SkBF), which consists of an initial peak (axon-reflex mediated) followed by a brief nadir and a secondary rise to a plateau. The aim of this study was to investigate whether heat provoked vasodilatation detects sympathetic vasomotor dysfunction and completeness of injury in patients with spinal cord injury (SCI). Twelve (seven complete, and five incomplete; level C4-L4) SCI patients, and nine healthy subjects as controls were studied. Thermostatic laser Doppler probes, which heat the skin locally, were placed on the dorsum of the hand and foot. SkBF was measured by laser Doppler flowmetry at baseline and at the first peak of vasodilatation (SkBF(max)). On the hand, SkBF at baseline and SkBF(max) were similar between the three groups. On the foot, SkBF at baseline was similar between the three groups but SkBF(max) was significantly diminished in complete SCI patients compared with controls (P < 0.01). In conclusion, heat provoked axon-reflex vasodilatation was diminished in the foot, below the level of lesion, in complete SCI. This test, that evaluates localized sympathetic vasomotor dysfunction, may be a useful non-invasive technique to detect completeness of autonomic disruption after SCI.