SEX-DIFFERENCES IN CONTROL OF CUTANEOUS BLOOD-FLOW
SEX-DIFFERENCES IN CONTROL OF CUTANEOUS BLOOD-FLOW
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DOI：
10.1161/01.cir.82.5.1607
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发表时间：
1990-11-01
期刊：
影响因子：
37.8
通讯作者：
SHEPHERD, JT
中科院分区：
文献类型：
--
作者：
COOKE, JP;CREAGER, MA;SHEPHERD, JT
女性比男性更容易患雷诺病。本研究的目的是确定局部或中枢控制皮肤血流是否存在性别差异，这可能是女性雷诺病发病率增加的原因。为了评估皮肤血流量，在47名志愿者中分别通过流体体积描记法、水银应变计体积描记法或激光多普勒光谱法测量手部血流量（HBF）、手指血流量（FBF）或皮肤灌注（SP）。男性的基础HBF超过女性（12.1 . ±. 2.0与6.2 .+-相比。1.5 ml/100 ml/min）。同样，男性的FBF也超过了女性（19.5 +-. 4.1与7.7 .+-相比。1.8 ml/100 ml/min）。同样，男性的SP大于女性（270 . ±. 42对81 +-. 16个灌注单位）。然而，全身变暖（诱导热交感神经松解）后，女性的HBF超过男性，这表明女性较低的基础HBF是由于交感神经流出增加到四肢。精神紧张和深吸气降低男性的HBF和SP。巧合的是，这两种方法都增加了女性的HBF和SP。为了确定女性的这些矛盾反应是否是由于女性的基础交感神经张力升高，这些实验在男性身体冷却后重复以增加交感神经张力，在女性全身变暖后重复以减少交感神经张力。全身降温降低男性HBF和SP。在这些条件下，精神压力和深吸气引起血管舒张。在女性中，全身变暖10分钟会增加HBF。在这些条件下，精神压力和深吸气引起血管收缩。总之，女性的基础皮肤血流量减少。这似乎是由于交感神经张力的基础增加，而不是皮肤循环中的局部结构或功能差异。此外，在高水平的交感神经张力下，对心算和深吸气反应的反常血管舒张被揭露出来。皮肤血流的性别差异可能是年轻女性雷诺病发病率增加的原因。
Women are far more likely than men to suffer from Raynaud''s disease. The purpose of this study was to determine whether there are gender differences in local or central control of cutaneous blood flow that could account for the increased incidence of Raynaud''s disease in women. To assess cutaneous blood flow, hand blood flow (HBF), finger blood flow (FBF), or skin perfusion (SP) was measured by fluid plethysmography, mercury strain-gauge plethysmography, or laser Doppler spectroscopy, respectively, in 47 volunteers. Basal HBF in men exceeded that of women (12.1 .+-. 2.0 versus 6.2 .+-. 1.5 ml/100 ml/min). Likewise, FBF in men surpassed that of women (19.5 .+-. 4.1 versus 7.7 .+-. 1.8 ml/100 ml/min). Similarly, SP in men was greater than that of women (270 .+-. 42 versus 81 .+-. 16 perfusion units). However, after total body warming (to induce a thermal sympatholysis), HBF in women exceeded that of men, suggesting that the lower basal HBF in women was due to increased sympathetic outflow to the extremities. Mental stress and deep inspiration reduced HBF and SP in men. Paradoxically, both of these maneuvers increased HBF and SP in women. To determine whether these paradoxical responses in women were due to the women''s elevated basal sympathetic tone, these experiments were repeated after body cooling in men to increase sympathetic tone and after total body warming in women to reduce sympathetic tone. Total body cooling reduced HBF and SP in men. Under these conditions, mental stress and deep inspiration induced vasodilation. In women, total body warming for 10 minutes increased HBF. Under these conditions, mental stress and deep inspiration induced vasoconstriction. In conclusion, basal cutaneous blood flow is reduced in women. This appears to be due to a basal increase in sympathetic tone rather than to a local structural or functional difference in the cutaneous circulation. In addition, a paradoxical vasodilation in response to mental arithmetic and deep inspiration is unmasked at high levels of sympathetic tone. The gender differences in cutaneous blood flow may account for the increased incidence of Raynaud''s disease in young women.