以離子電泳雷射都普勒血流測量儀探討健康男性年齡對微循環擴張功能的影響

The Effect of Aging on Microvascular Function in Healthy Men by Iontophoresis with Laser Doppler Flowmetry

趙婉茹(Wan-Ju Chao) ； 林柏州(Po-Chou Lin) ； 劉千綺(Cian-Ci Liou) ； 謝明賢(Ming-Hsien Hsieh) ； 黃珏蓉(Chueh-Lung Hwang) ； 吳英黛(Ying-Tai Wu)

《物理治療》 36卷3期 (2011/09) Pp. 208-215

摘要

背景及目的：乙醯膽鹼（acetylcholine，Ach）、硝普納（sodium nitroprusside，SNP）離子電泳合併雷射都普勒血流測量儀，可檢測內皮依賴性和非依賴性之微循環擴張功能。本研究以不同劑量的離子電泳，檢測其信度和評估參數，並以此探討年齡對微循環功能影響。方法：本研究徵召18位年輕（21.6±1.6歲）和20位中老年（57.0±7.5歲）男性，接受0.5％Ach和SNP相隔4分鐘、劑量各為4、8、16 mC的離子電泳。其中12位年輕男性一週內接受再測，計算每一劑量反應之平均血流量、至最大血流量之斜率（速度）、曲線下面積（大小）和最後之血流改變量除以基礎血流量之反應性。結果兩藥物在8和16mC平均血流量、8mC反應大小、血流反應性、以及Ach在16mC反應大小具有中等信度（組內相關係數0.493─0.708）。每階段兩組的平均血流量與反應大小顯著增加，然而中老年男性SNP在8和16mC的平均血流量與反應大小未顯著上升。中老年男性Ach在8和16mC平均血流量和反應大小，與血流反應性均較年輕組低。結論：此一檢測可行，且具中等信度。中老年男性之內皮依賴性微循環擴張功能較年輕者下降。

關鍵字

離子電泳 ； 雷射都普勒血流測量儀 ； 劑量與反應 ； 再測信度 ； 年齡

並列摘要

Background and Purpose: Iontophoresis by acetylcholine (Ach) and sodium nitroprusside (SNP) with laser Doppler flowmetry (LDF) has been used to evaluate endothelium-dependent and -independent microvascular function. This study used three doses of Ach and SNP in one test with different parameters to evaluate the test- retest reliability, and compared the differences in microvascular response between groups of young healthy men and middle-aged and older persons. Methods: Eighteen young healthy men (aged 21.6±1.6 years) and 20 middle-aged and older men (aged 57.0±7.5 years) participated into the study. Each participant underwent an iontophoresis test of 0.5% Ach and SNP by constant electronic currents of 0.2 mA for 20, 40,and 80 seconds interspersed by 4 minutes with LDF measurements, representing doses of 4, 8,and 16 mC. Among them, twelve young healthy men took another test within a week. The mean blood flux in 4-minute interval, the slope from the start of the response to the maximum, area under curve in response period for each dose, and the mean of blood flux of 16mC minus baseline value divided by baseline value were calculated to represent mean blood flux, the response speed, magnitude, and overall reactivity respectively. Results: The mean blood flux at 8 and 16 mC, the magnitudes at 8 mC, and the overall reactivity of these two vasodilators, and the response magnitude of Ach at 16 mC were moderately reliable with intraclass correlation coefficients ranged from 0.493 to 0.708. Both groups had significantly increased mean blood flux and response magnitude with increasing doses, except no differences for SNP at 8 and 16 mC in the middle-aged and older subjects. The middle-aged and older men had lower mean blood flux and response magnitude of Ach at 8 and 16 mC, and overall reactivity of Ach compared with the young counterparts. Conclusions: This method is feasible with moderate reliability. The middle-aged and older men had reduced endothelium-dependent microvascular dilatation.

並列關鍵字

Iontophoresis ； Laser Doppler flowmetry ； Dose-response ； Test-retest reliability ； Aging