Studies of Peripheral Circulation during Sickle‐Cell Crisis
Studies of Peripheral Circulation during Sickle‐Cell Crisis
复制标题
镰状细胞危机期间外周循环的研究
作者：
F. Manfredi;Angelo P. Spoto;H. Saltzman;H. Sieker
在18例黑人镰状细胞性贫血或镰状细胞血红蛋白C病患者中，测量了肱动脉与上肢浅静脉和深静脉系统之间的氧和pH梯度。在危机期间获得的结果与无症状患者的结果进行了比较。在11例无症状患者中观察到动脉血氧不饱和度，氧和pH的动静脉梯度正常。异常低的动静脉梯度的氧气和pH值，主要是由于异常的静脉值，被发现时，从皮肤区域的血液引流与动脉样本相比，在7例患者的研究在急性危机。症状缓解后复查的5例患者动静脉差恢复正常。有证据表明，在危象期间，静脉血的动脉化是浅表循环中解剖或功能旁路的结果，因此氧气不会被组织清除。据推测，血管神经机制可能是镰状细胞危象的促发因素。它还建议，低动静脉氧梯度或动脉化浅静脉血液可作为一种实验室辅助诊断镰状细胞危象在不确定的情况下。
In 18 Negro patients with sickle-cell anemia or sickle cell-hemoglobin C disease, gradients of oxygen and pH were measured between brachial artery and superficial and deep venous system of the upper extremity. The results obtained during crisis were compared with those obtained from asymptomatic patients. Arterial oxygen unsaturation, with normal arteriovenous gradients for oxygen and pH was observed in the 11 asymptomatic patients. Unusually low arteriovenous gradients for oxygen and pH, mainly due to abnormal venous values, were found when blood draining from cutaneous areas was compared with arterial samples in the 7 patients studied during acute crisis. The 5 patients restudied after symptoms subsided showed a return toward normal of arteriovenous differences. The evidence suggests that during crisis arterialization of venous blood is the result of anatomic or functional by passes in the superficial circulation, so that oxygen is not removed by the tissues. It is postulated that a vascular neurogenic mechanism may be the precipitating factor in sickle-cell crisis. It is also suggested that a low arteriovenous oxygen gradient or arterialization of superficial vein blood may be used as a laboratory aid in establishing the diagnosis of sickle-cell crisis in uncertain cases.