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[雷诺氏病患者热阈值的测定。2例临床病例的初步报告]

[The determination of the thermal threshold in subjects with Raynaud's disease. A preliminary report of 2 clinical cases].

作者信息

Luca S, Romeo S

机构信息

Cattedra e Scuola di Specializzazione in Chirurgia Vascolare, Ospedale Garibaldi, Università degli Studi, Catania.

出版信息

Minerva Cardioangiol. 1999 Jun;47(6):213-7.

Abstract

BACKGROUND

The onset of Raynaud's phenomenon is mainly provoked by cold stimuli which, in patients affected by Raynaud's disease, are milder than those able to provoke the same phenomenon in healthy subjects. Therefore, it is reasonable to theorize the existence of a "thermal threshold", below which it is more likely for a Raynaud's phenomenon to be provoked. The aim of this investigation is to determine whether a thermal threshold in Raynaud's disease exists and if it can be used as a practical tool for preventing the complications of Raynaud's disease (digital gangrene and ulcers), whose onset is strictly related to the frequency of the phenomena.

METHODS

Two patients affected, respectively, by slight Raynaud's phenomenon secondary to peripheral neuropathy (Case 1), by severe Raynaud's phenomenon associated with mixed connective tissue disease (Case 2), were asked to write a note about the phenomena and the days of their onset, within a period of three months. Afterwards, all data were related to the daily ground maximum temperature occurred in the period of study.

RESULTS AND CONCLUSIONS

These preliminary results show an interesting correlation between this new parameter and the clinical data, the thermal threshold being higher in more severe cases. It was equal to 22 degrees C in the patient affected by slight phenomenon (Case 1), and equal to 27 degrees C in the severe phenomenon (Case 2). This method for evaluating the thermal threshold in these two cases of Raynaud's disease (the greater the figure, the more severe the case) allowed both the clinical assessment of the pathology and the prevention of secondary complications.

摘要

背景

雷诺现象的发作主要由寒冷刺激引发,在雷诺病患者中,这些刺激比在健康受试者中引发相同现象的刺激更为轻微。因此,推测存在一个“热阈值”是合理的,低于该阈值更有可能引发雷诺现象。本研究的目的是确定雷诺病中是否存在热阈值,以及它是否可以作为预防雷诺病并发症(手指坏疽和溃疡)的实用工具,这些并发症的发生与该现象的发作频率密切相关。

方法

分别选取两名患者,一名患有继发于周围神经病变的轻度雷诺现象(病例1),另一名患有与混合性结缔组织病相关的重度雷诺现象(病例2),要求他们在三个月内记录有关这些现象及其发作日期的笔记。之后,所有数据均与研究期间每日地面最高温度相关。

结果与结论

这些初步结果显示了这一新参数与临床数据之间的有趣关联,在病情较重的病例中热阈值更高。患有轻度现象的患者(病例1)的热阈值为22摄氏度,患有重度现象的患者(病例2)的热阈值为27摄氏度。这种评估这两例雷诺病热阈值的方法(数值越大,病情越严重)既有助于对病情进行临床评估,也有助于预防继发性并发症。

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