Effects of chronic sympathectomy on vascular function in the human forearm
Effects of chronic sympathectomy on vascular function in the human forearm
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DOI：
10.1152/japplphysiol.01025.2001
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发表时间：
2002-05-01
影响因子：
3.3
通讯作者：
Joyner, MJ
中科院分区：
文献类型：
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作者：
Eisenach, JH;Clark, ES;Joyner, MJ
为了确定慢性手术交感神经切除术是否改变了内皮功能，我们将ACh、异丙肾上腺素、硝普钠（NTP）和一氧化氮合酶抑制剂N-G-单甲基-L-精氨酸（L-NMMA）输注到9名患者的肱动脉中，这些患者在胸交感神经切除术治疗多汗症后5-64个月。年龄和性别匹配的对照也进行了研究。前臂血流量（FBF）通过静脉闭塞体积描记法测量。下体负压用于评估反射性血管收缩反应。酪胺也通过肱动脉给药，酪胺在局部起作用并引起交感神经释放去甲肾上腺素。患者静息时FBF为2.5 +/- 0.4 ml.dl（-1）.min（-1），对照组为2.5 +/- 0.3 ml.dl（-1）.min（-1）（P = 0.95）。患者对下体负压的正常缩血管反应消失。相比之下，酪胺产生剂量依赖性血管收缩的患者是相同的控制。ACh的剂量-反应曲线在患者和对照组中相似，最大值分别为19.3 ± 4.4和25.5 ± 2.8 ml.dl（-1）.min（-1）。L-NMMA降低基线FBF相似，并降低两组对ACh的最大FBF反应（患者8.9 +/- 3.5 vs.对照组9.7 +/- 2.5 ml.dl（-1）.min（-1））。两组中L-NMMA对异丙肾上腺素的血管舒张作用相似，且减弱程度相同。患者和对照组对NTP的反应相似，不受L-NMMA的影响。我们的结论是，在人类中，慢性交感神经切除术不会导致前臂血管功能的重大中断。对酪胺的正常血管收缩反应表明前臂中存在未被LBNP参与的活性交感神经。
To determine whether endothelial function is altered by chronic surgical sympathectomy, we infused ACh, isoproterenol, nitroprusside (NTP), and the nitric oxide synthase inhibitor N-G-mono-methyl-L-arginine (L-NMMA) into the brachial arteries of nine patients 5-64 mo after thoracic sympathectomy for hyperhidrosis. Age- and gender-matched controls were also studied. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. Lower body negative pressure was used to assess reflex vasoconstrictor responses. Tyramine, which acts locally and causes norepinephrine release from sympathetic nerves, was also administered via the brachial artery. FBF at rest was 2.5 +/- 0.4 ml.dl(-1).min(-1) in the patients and 2.5 +/- 0.3 ml.dl(-1).min(-1) in the controls (P = 0.95). The normal vasoconstrictor responses to lower body negative pressure were abolished in the patients. By contrast, tyramine produced dose-dependent vasoconstriction in the patients that was identical to that of controls. The dose-response curves to ACh were similar in patients and controls, with maximum values of 19.3 +/- 4.4 vs. 25.5 +/- 2.8 ml.dl(-1).min(-1), respectively. L-NMMA reduced baseline FBF similarly and reduced the maximal FBF response to ACh in both groups (patients 8.9 +/- 3.5 vs. controls 9.7 +/- 2.5 ml.dl(-1).min(-1)). The vasodilation to isoproterenol was similar and blunted to the same extent in both groups by L-NMMA. The responses to NTP in patients and controls were similar and not affected by L-NMMA. We conclude that, in humans, chronic surgical sympathectomy does not cause major disruptions in vascular function in the forearm. The normal vasoconstrictor responses to tyramine indicate that there were viable sympathetic nerves in the forearm that were not engaged by LBNP.