Shepherd R F, Shepherd J T
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Int Angiol. 1992 Jan-Mar;11(1):41-5.
Much has been learned about the complexity of the local, humoral and nervous factors regulating the normal behavior of the skin blood vessels, and many studies have addressed how this knowledge might relate to the causation of primary Raynaud's disease. Despite this, the mechanism(s) responsible for the attacks of digital vasospasm remain an enigma. A key question is whether these attacks represent an exaggeration of the normal mechanisms causing constriction of the digital vessels with local cooling, or are due to a specific abnormality. In this article it is suggested that multiple factors are responsible, including the possibility of co-transmitters released with norepinephrine from the sympathetic nerves, increased activation of beta 2-adrenoceptors on the nerve endings, a shift in the balance of alpha 1 and alpha 2 adrenoceptors on the vascular smooth muscle and in endothelium-derived relaxing and contracting factors, and altered interactions of the endothelium with the blood elements including the effects of increased platelet serotonin.
关于调节皮肤血管正常行为的局部、体液和神经因素的复杂性，我们已经了解了很多，并且许多研究探讨了这些知识与原发性雷诺病病因之间的关系。尽管如此，导致手指血管痉挛发作的机制仍然是个谜。一个关键问题是，这些发作是正常的因局部冷却导致手指血管收缩机制的过度表现，还是由特定异常引起的。本文认为，多种因素起作用，包括交感神经释放的去甲肾上腺素与共递质一同释放的可能性、神经末梢上β2肾上腺素能受体的激活增加、血管平滑肌和内皮衍生的舒张及收缩因子上α1和α2肾上腺素能受体平衡的改变，以及内皮与血液成分相互作用的改变，包括血小板5-羟色胺增加的影响。
