Avtor/Urednik		Mlačak, Blaž; Ostojič, Željko; Ivka, Branimir; Kapš, Rafko; Vukovič, Miro
Naslov		Motnje pretoka v mikrocirkulaciji pri bolnikih s kronično vensko insuficienco
Prevedeni naslov		Blood flow disturbances in patients with chronic venous insufficiency
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 69, št. 10
Leto izdaje		2000
Obseg		str. 663-6
Jezik		slo
Abstrakt		Background. The aim of this study was to investigate patients with clinical stages II and III of chronic venous insufficiency (CVI) by laser Doppler fluxmetry (LDF) in order asses whether these clinical entities correspond to specific flow regulation. Methods. 2 groups of subjects were incorporated in the study. The first group included 30 patients with CVI stage II or III, and the second (control) group included 30 persons with healthy veins of lower limbs. Microcirculation investigations were carried out at rest and after hemodynamics tests. Blood flow changes were measured by laser Doppler fluxmetry. Changes in the laser Doppler flux minus the "biological zero" value were measured after 3 minutes of arterial occlusion and by experimental venous hypertension (cuff pressure 70 mm Hg to provoke venoarteriolar reflex) and expressed relatively to the pretest resting value. Results. Resting LDF was significantly higher in the group I (patients with CVI II and CVI III stage) as compared to the group with healthy subjects (p<0,001). In patients (with CVI II and CVI III stage group I LDF) remained nearly unchanged after arterial occlusion (5.5% flow increase vs. 445% in the group II-healthy controls (p<0,001). Experimental venous hypertension (cuff press 70 mm Hg) led to profound reduction of flux in both 2 groups (I-91.2%; II-90.5%). The venoarteriolar reflex (VAR) is not impaired in legs with CVI when compared to healthy legs. Conclusion. LD fluxmetry helps to distinguish patients with CVI stage II and III from healthy subjects, particulary when measurements are performed during reactive hyperemia test.
Izvleček		Izhodišča. Cilj raziskave je bil pregledati bolnike z drugim in tretjim stadijem kronične venske insuficience (KVI) z namenom, da ocenimo, ali je za določeno klinično sliko KVI značilna sprememba pretoka v mikroirkulaciji. Metode. Raziskali smo 2 skupini preiskovancev. Prva skupina je zajela 30 bolnikov z drugim in trtjim stadijem KVI in druga (kontrolna) 30 oseb z zdravimi venami na spodnjih udih. Pretoke v mikrocirkulaciji smo merili s pomočjo laserskega dopplerskega merilnika (LD) pretokov v mirovanju in po hemodinamskih testih. Spremembe LD-pretoka, zmanjšane za vrednosti "biološke ničle", so bile registrirane po 3-minutnem arterijskem zažemu, lokalnem gretju kože in pri eksperimentalni venski hipertenziji (70 mm Hg), s katero smo izzvali venoarteriolarni refleks (VAR). Vrednost LD-pretoka so izražene kot relativne v primerjavi z vrednostmi v mirovanju. Rezultati. LD-pretok v mirovanju je bil pomembno večji v prvi skupini (bolniki z drugim in tretjim stadijem KVI) v primerjavi s skupino zdravih preiskovancev (p<0,001). Pri bolnikih z drugim in tretjim stadijem KVI (skupina I) je LD-pretok ostal praktično nespremenjen po arterijskem zažemu (5,5-odstotno zvečanje pretoka proti 445% pri preiskovancih z zdravimi venami p<0,001). Po lokalnem gretju kože je bil LD-pretok pri zdravih preiskovancih 8,7-krat večji v primerjavi z vrednostmi LD-pretoka v mirovanju (p<0,001), medtem ko je bilo pri osebah s KVI to zvečanje samo 54% (statistično nepomembno). Umetna venska hipertenzija (tlak v manšeti 70 mm Hg) je povzročila pomembno zmanjšanje pretoka v obe skupini (I-91,2%:II-90,5%). V primerjavi z zdravimi nogami se VAR ni poslabšal. Zaključki. Z uporabo LD-merilnika pretokov lahko razločimo osebe s KVI (stadij II in III) od oseb brez KVI, posebej v primeru, če so meritve opravljene po testu reaktivne hiperemije.
Deskriptorji		VENOUS INSUFFICIENCY MICROCIRCULATION LASER-DOPPLER FLOWMETRY VARICOSE VEINS