Vpliv aerobne telesne vadbe na kožni krvni pretok in kožni parcialni tlak kisika : diplomsko delo

Nosan, Tadeja (author), Potočnik, Nejka (mentor), Kacin, Alan (co-mentor)

Uvod: Kožna mikrocirkulacija je pomembna za ohranjanje homeostaze telesa. Dosedanje raziskave so pokazale različne velikosti krvnega pretoka glede na tip kože in različen odziv pretoka na telesno vadbo. Z merjenjem kožnega pretoka krvi z Laser-Dopplerjem ne moremo ločiti nutritivnega in funkcionalnega krvnega toka krvi med seboj. Merilo nutritivnega pretoka bi bil lahko transkutani parcialni tlak kisika v koži. Glede na pregledano literaturo je naša raziskava prva, ki vključuje merjenje transkutanega parcialnega tlaka kisika vzporedno z Laser-Dopplerskim pretokom v poraščeni in neporaščeni koži v mirovanju ter med zmerno aerobno telesno vadbo in po njej. Namen: Namen diplomskega dela je bil ugotoviti odziv Laser-Dopplerskega pretoka in transkutanega parcialnega tlaka kisika v neporaščeni (prstna blazinica) in poraščeni (podlaket) koži pred vadbo, med vadbo in po aerobni vadbi na sobnem kolesu in ta odziv povezati z anatomskimi in funkcionalnimi značilnostmi obeh tipov kože. Metode dela: V raziskavi je sodelovalo 9 zdravih moških preiskovancev. Pri vsakem smo leže pred naporom, sede pred naporom, med naporom na sobnem kolesu in po naporu merili transkutani parcialni tlak kisika, pretok krvi in temperaturo v obeh delih kože ter frekvenco srčnega utripa. Podatke smo nato z ustreznimi statističnimi programi in testi analizirali, da bi ugotovili statistično pomembne razlike ter korelacije. Rezultati: V poraščeni koži se je kožna žilna prevodnost (kožna žilna prevodnost = Laser-Dopplerski pretok/srednji arterijski tlak) med vadbo povečala, po vadbi pa vrnila na vrednost v mirovanju pred naporom. V pozitivni linearni korelaciji s kožno žilno prevodnostjo se je spreminjal transkutani parcialni tlak kisika v tej koži. V neporaščeni koži se je kožna žilna prevodnost med vadbo zmanjšala, po vadbi pa vrnila na prvotno vrednost. Transkutani parcialni tlak kisika se je v tej koži med vadbo zniževal, pri večjih naporih povečal, v fazi počitka pa zmanjševal, linearne povezave s kožno žilno prevodnostjo nismo odkrili. Razprava in sklep: Za odvajanje toplote s kože je med vadbo odgovorna poraščena koža, po vadbi pa s povečanjem kožne žilne prevodnosti to nalogo prevzame neporaščena koža. Ker transkutani parcialni tlak kisika v neporaščeni koži po naporu ne sledi kožni žilni prevodnosti, ampak se zmanjšuje tako kot v poraščeni koži, lahko sklepamo, da se kožna žilna prevodnost poveča zaradi odpiranja arteriovenskih anastomoz. Sklepamo, da transkutani parcialni tlak kisika prikazuje prehransko mikrocirkulacijo. Povečanje parcialnega tlaka kisika v koži med telesno vadbo bi bilo lahko koristno pri celjenju kroničnih ran. Z zmanjšanjem prehranske cirkulacije ob velikem pretoku skozi funkcionalno cirkulacijo v neporaščeni koži bi lahko pojasnili simptome eritromelalgije.

• Language: Slovenian
• Keywords: kožna mikrocirkulacija, termoregulacija, pretok krvi v koži, pO2 v koži
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-106269
• COBISS.SI-ID: 5582699
• Publication date in RUL: 19.02.2019

Secondary language

• Language: English
• Title: The influence of acute aerobic exercise on laser-Doppler flow in the skin and transcutaneous oxygen pressure : diploma work

Abstract

Introduction: The cutaneous microcirculation is important to maintain body homeostasis. The findings so far showed different response of skin blood flow according to the skin type and different response as per exercise. By measuring only skin blood flow by laser-Doppler, we cannot distinguish between nutritional and functional part of the microcirculation. A possible way of measuring nutritional skin blood flow could be by recording the cutaneous pO2. To our knowledge, our study is the first one which includes cutaneous pO2 measurement in addition to laser-Doppler flow in acral skin during exercise. Purpose: The purpose of this thesis is to find out the response of the cutaneous microcirculation in acral (finger pad) and non-acral (forearm) skin before exercise, during exercise, and after exercise on exercise bicycle, and to relate this response to anatomic and functional characteristics of both skin types. Methods: 9 healthy volunteers (all men) participated in our study. For every volunteer, we measured tcpO2, skin blood flow, and temperature on both skin sites. We also measured heart rate. We did measurements in a lying position before exercise, sitting before exercise, during exercise on bicycle, and resting after exercise. Data was later analysed using appropriate statistical programs and tests with the significance level of 0.05. Results: Cutaneous vascular conductance (= laser-Doppler flow / mean arterial pressure) in non-acral skin increased during exercise and returned to baseline levels after exercise. Cutaneous pO2 in non-acral skin was changing in positive linear correlation with cutaneous vascular conductance. Cutaneous vascular conductance in acral skin decreased during exercise, and returned to baseline levels after the exercise. Cutaneous pO2 increased during higher loads and decreased during rest. We did not find any linear correlation between cutaneous pO2 and cutaneous vascular conductance in acral skin. Discussion and conclusion: During exercise, non-acral skin is responsible for heat elimination. This task is taken over by acral skin after exercise. Cutaneous vascular conductance increases, but cutaneous pO2 does not follow and decreases. We conclude, that increase in cutaneous vascular conductance in acral skin after exercise occurs because of the arteriovenous anastomoses opening. Cutaneous pO2 is an indicator of nutritional part of the microcirculation. Increase in pO2 of the skin during exercise could be beneficial for chronic wounds healing, and the decrease in pO2 in acral skin could be the cause for symptoms of erythromelalgia.

• Keywords: cutaneous microcirculation, termoregulation, skin blood flow, pO2 in skin