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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">microcirculation</journal-id><journal-title-group><journal-title xml:lang="ru">Регионарное кровообращение и микроциркуляция</journal-title><trans-title-group xml:lang="en"><trans-title>Regional blood circulation and microcirculation</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-6655</issn><issn pub-type="epub">2712-9756</issn><publisher><publisher-name>Academician I.P. Pavlov First St. Petersburg State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24884/1682-6655-2012-11-1-35-44</article-id><article-id custom-type="elpub" pub-id-type="custom">microcirculation-475</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Микроциркуляторный кровоток в коже кисти у пациентов с артериовенозной фистулой, находящихся на лечении программным гемодиализом.</article-title><trans-title-group xml:lang="en"><trans-title>Microcirculatory blood flow in the skin of hands in patients with arteriovenous fistula in treatment program hemodialysis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лобов</surname><given-names>Г. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Lobov</surname><given-names>G. I.</given-names></name></name-alternatives><email xlink:type="simple">gilobov@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гурков</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Gurkov</surname><given-names>A. S.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дворецкий</surname><given-names>Д. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Dvoretsky</surname><given-names>D. P.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Институт физиологии им. И. П. Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pavlov Institute of Physiology, Saint-Petersburg</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="epub"><day>30</day><month>03</month><year>2012</year></pub-date><volume>11</volume><issue>1</issue><fpage>35</fpage><lpage>44</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лобов Г.И., Гурков А.С., Дворецкий Д.П., 2012</copyright-statement><copyright-year>2012</copyright-year><copyright-holder xml:lang="ru">Лобов Г.И., Гурков А.С., Дворецкий Д.П.</copyright-holder><copyright-holder xml:lang="en">Lobov G.I., Gurkov A.S., Dvoretsky D.P.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.microcirc.ru/jour/article/view/475">https://www.microcirc.ru/jour/article/view/475</self-uri><abstract><p>Цель исследования - изучить параметры микроциркуляции в коже пальца руки методом лазерной допплеровской флоуметрии (ЛДФ) с вейвлет-анализом параметров кровотока у гемодиализных пациентов с артериовенозной фистулой в нижней трети предплечья. Обследованы 86 пациентов (34 мужчины и 52 женщины). Средний возраст пациентов был 48 (диапазон - 33-62) лет. Преимуществом ЛДФ является возможность атравматично и с высокой чувствительностью зарегистрировать минимальные изменения в локальном кровотоке in vivo. С помощью лазерного допплеровского флоуметра LAKK-02 в коже второго пальца руки измеряли базальный кровоток и его колебания, а также уровень кислородной сатурации крови и относительную концентрацию гемоглобина в ткани. Параметры кровотока в коже пальца измеряли перед формированием артериовенозной фистулы и через 3 дня, 1, 3, 6, 12 и 24 месяца после ее создания. Результаты исследования показывают, что уровень перфузии в коже пальца до формирования артериовенозной фистулы составил в среднем 17,14±5,21 пф. ед., он снизился сразу же после формирования артериовенозной фистулы на 17 %, после 6 месяцев функционирования АВФ - на 33 % и после 24 месяцев - на 52 % от исходной величины. По мере функционирования АВФ модуляция микроциркуляции существенно возрастала. Отличительной особенностью, выявленной в этом исследовании, помимо снижения эндотелиальных метаболических процессов и симпатического контроля микроциркуляции, было значительное увеличение миогенной активности в коже (через 24 месяца функционирования АВФ - в три раза). Следует отметить также, что сатурация кислорода в тканях кисти через 24 месяца функционирования АВФ снизилась с 77,4±11,9 % до 51,1±8,4 %, а относительное содержание гемоглобина - с 11,41±2,35 % до 7,25±1,71 %. Мы приходим к заключению, что после формирования АВФ изменения кровотока в тканях кисти на фоне уменьшения уровня перфузии сопровождаются значительным увеличением тонуса артериоло-венулярных шунтов и дилатацией прекапиллярных сфинктеров. Компенсаторные изменения на уровне микроциркуляторного русла перераспределяют поток крови в пользу капилляров, что ведет к увеличению потребления тканями кислорода.</p></abstract><trans-abstract xml:lang="en"><p>The aim of our study was to investigate the parameters of microcirculation in the skin of arm finger on the basis of laser Doppler flowmetry (LDF) with a wavelet analysis of the blood flow in haemodialysis patients with an arteriovenous fistula in the lower third of the forearm. Of our 86 patients, 34 were male and 52 were female. Mean age was 48 (range 33-62) years.The advantage of laser Doppler flowmetry in humans is the fact that it is noninvasive and sensitive enough to record small changes in local blood flow in vivo. With the laser Doppler flowmeter LAKK-02 in the skin of arm second finger measured basal blood flow, blood oxygen saturation level and the relative concentration of hemoglobin in the tissue. Blood flow was measured before the formation of an arteriovenous fistula and 3 days, 1, 3, 6, 12, 24 months after formation of an arteriovenous fistula.Blood flow in the skin of the finger to the formation of an arteriovenous fistula was an average of 17.14±5.21 perfusion unit, he fell immediately after the formation of an arteriovenous fistula on 17 %, after 6 months on 33 %, and after 24 months - on 52 % from datum level. Our findings suggest that the modulation of the microcirculation in process functioning AVF greatly increased: to significantly reduced the amplitude of neurogenic oscillation of blood flow and 3-fold increased the amplitude of the myogenic oscillation. 6 months later revealed a significant reduction in the amplitude of endothelial oscillation. It should be noted also that the oxygen saturation in tissues after 24 months of functioning AVF has decreased from 77.4±11.9 to 51.1±8.4 %, and the relative hemoglobin content - from 11.41±2.35 to 7.25±1.71 %.We conclude, that changes in the modulation of blood flow in process functioning AVF resulted in a significant increase tone of arteriolovenulyar shunts and dilatation of precapillary sphincters in skin, reduced oxygen saturation in tissues and relative content of hemoglobin in the tissues. Compensatory changes at the level of microvasculature despite a decline in blood flow and hemoglobin in the tissues contributed to the redistribution of blood flow in favor of the nutritive stream and increase of consumption of tissues oxygen.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>артериовенозная фистула</kwd><kwd>микрокровоток</kwd><kwd>показатель микроциркуляции</kwd><kwd>амплитуда нейрогенных и миогенных колебаний</kwd><kwd>показатель шунтирования</kwd></kwd-group><kwd-group xml:lang="en"><kwd>arteriovenous fistula</kwd><kwd>local blood flow</kwd><kwd>baseline LDF</kwd><kwd>neurogenic and myogenic oscillation</kwd><kwd>shunting indicator</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Бикбов, Б. Т. Состояние заместительной терапии больных с хронической почечной недостаточностью в Российской Федерации в 1998-2005 гг. 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