Pit'ha J, Oliva I
Pracovistĕ preventivní kardiologie IKEM, Praha.
Vnitr Lek. 1999 Jul;45(7):433-7.
The term vasoneuroses comprises functional disorders of peripheral vessels, in particular arterioles, manifested by vasospasms on the periphery of the upper and lower extremities, more rarely the nose and ears. The main representant of these diseases is a disorder manifested by episodic attacks of ischaemia of the fingers, in particular of the upper extremities--Raynaud's phenomenon (RP) which has two forms: primary RP (Raynaud's disease) where no other basic disease is diagnoses during a two-year period. secondary RP (Raynaud's phenomenon) as an associated symptom of other, in particular systemic diseases. The etiology and pathology of Raynaud's phenomenon has not been elucidated satisfactorily so far. With regard to the variety and scope of detected functional and morphological abnormalities RP is rather multifactorial, caused by an unbalanced action of local and systemic factors affecting the sensitivity of the vascular wall to spastic stimuli. Treatment therefore remains symptomatic. It is restricted to administration of vasodilatating agents, in more severe cases sympathectomy is considered; it is important to rule out another basic disease. Vasoneuroses include also acrocyanosis, livedo reticularis and erythromelalgia. In the case of erythromelalgia it is important to rule out secondary causes (hypertension and polycythemia vera), otherwise it is not necessary to use pharmacological means to influence these diseases because of their relatively harmless course.
血管神经功能紊乱这一术语包括外周血管，尤其是小动脉的功能障碍，表现为上肢和下肢外周血管痉挛，在鼻子和耳朵出现痉挛的情况较为少见。这些疾病的主要代表是一种以手指缺血性发作，尤其是上肢缺血性发作为特征的病症——雷诺现象（RP），它有两种形式：原发性RP（雷诺病），即在两年期间未诊断出其他基础疾病；继发性RP（雷诺现象），作为其他疾病，尤其是全身性疾病的相关症状。到目前为止，雷诺现象的病因和病理尚未得到令人满意的阐明。鉴于所检测到的功能和形态异常的多样性和范围，RP是多因素的，由影响血管壁对痉挛刺激敏感性的局部和全身因素的不平衡作用引起。因此，治疗仍然是对症治疗。仅限于使用血管扩张剂，在更严重的情况下考虑进行交感神经切除术；排除其他基础疾病很重要。血管神经功能紊乱还包括手足发绀症、网状青斑和红斑性肢痛症。对于红斑性肢痛症，排除继发性病因（高血压和真性红细胞增多症）很重要，否则由于这些疾病病程相对无害，无需使用药物手段来治疗。
