Laser Doppler measurement of rectal mucosal blood flow
Laser Doppler measurement of rectal mucosal blood flow
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作者：
Emmanuel, AV;Kamm, MA
背景-肠道粘膜血流量测量用于研究各种疾病和可能的外在神经功能。目的-确定最佳测量标准并验证该技术作为外在自主肠道神经支配活动水平的测量。方法-在 26 名健康志愿者中，在距肛门 10 厘米处应用激光多普勒粘膜探头。还研究了 9 名失禁患者对吸入沙丁胺醇 200 μg 和异丙托铵 40 μg、静脉注射美托洛尔 2.5 mg 和直接骶神经电刺激的反应。 结果 在相同条件下研究的受试者在第 2 天、第 3 天和第 4 天的变异系数分别为 0.06、0.05 和 0.06。标准膳食后平均粘膜血流量增加。吸烟后血流量下降 15 分钟，并在 30 分钟时恢复到基线。 0900、1200、1600 和 2200 时的禁食测量结果相似。血流量与身体尺寸呈负相关，但与年龄无关。卵泡期粘膜流量比黄体期少且可重复性更高。男性的粘膜血流量最高，绝经后女性的粘膜血流量最低。吸入沙丁胺醇不会改变血流；异丙托溴铵显着减少，美托洛尔和骶神经刺激增加血流。结论-通过激光多普勒血流计测量肠粘膜血流具有高度可重复性。饮食、吸烟、体型、性别、排卵状态和月经期影响血流自主活性药物和神经刺激引起的粘膜血流变化证实了粘膜微循环作为外在神经活动测量的作用。
Background-Gut mucosal blood flow measurement is used to study a variety of disorders and possibly extrinsic neural function.Aims-To determine optimal measurement criteria and validate this technique as a measure of level of activity of extrinsic autonomic gut innervation.Methods-In 26 healthy volunteers a laser Doppler mucosal probe was applied 10 cm from the anus. Response to inhaled salbutamol 200 mu g and ipratropium 40 mu g, intravenous metoprolol 2.5 mg, and direct sacral nerve electrostimulation tin nine incontinent patients was also studied.Results The coefficient of variation for subjects studied under identical conditions on two, three, and four days was 0.06, 0.05, and 0.06, respectively. Mean mucosal blood flow increased after a standard meal. Blood flow decreased for 15 minutes after smoking and returned to baseline at 30 minutes. Fasted measurements at 0900, 1200, 1600, and 2200 were similar. There was a negative correlation between blood flow and body size but not age. Follicular phase mucosal flow was less and more reproducible than luteal. Mucosal blood flow was highest in men and lowest in postmenopausal women. Inhaled salbutamol did not change blood flow; ipratropium significantly reduced, and metoprolol and sacral nerve stimulation increased flow.Conclusions-Measurement of gut mucosal blood flow by laser Doppler flowmetry is highly reproducible. Eating, smoking, body size, sex, ovulatory status, and menstrual phase influence blood flow Changes in mucosal blood flow induced by autonomically active drugs and nerve stimulation confirm the role of the mucosal microcirculation as a measure of extrinsic nerve activity.