Spengler M I, Svetaz M J, Leroux M B, Leiva M L, Bottai H M
Departamento de Ciencias Fisiológicas, Cátedra de Física Biológica, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, CP 2000, Rosario, Argentina.
Clin Hemorheol Microcirc. 2004;30(1):17-24.
Raynaud's phenomenon is a paroxysmal and reversible vasospasm affecting generally the acral circulatory regions. The relevance of the haemorheological alterations in these patients, as a source of ischemic events has been neglected. The objective of the present work was to evaluate and correlate the rheological blood properties, some biochemical parameters, e.g., plasma fibrinogen and immunoglobulin levels, and periungual capillaroscopy. The explicative variables considered were: blood viscosity, plasma viscosity, erythrocyte rigidity index, plasma fibrinogen, erythrocyte sedimentation rate, erythrocyte aggregate size, erythrocyte aggregation rate and serum immunoglobulin (IgG and IgM). The response variable was the nailfold capillary pattern categorised as either normal or pathological. Fibrinogen, erythrocyte aggregation rate and IgM are significantly higher in patients with a pathological pattern in comparison with patients bearing a normal one. The statistical analysis enabled us the modelling of the pathological pattern occurrence probability in function of plasma fibrinogen. Consequently, 100 mg/dl plasma fibrinogen increase, increases twice the probability of presenting a pathological pattern. Therefore, we can conclude that high levels of fibrinogen in Raynaud's phenomenon patients are associated with impaired skin microcirculation assessed by periungual capillaroscopy.
雷诺现象是一种阵发性且可逆的血管痉挛,通常影响肢体末端循环区域。这些患者血液流变学改变作为缺血事件来源的相关性一直被忽视。本研究的目的是评估血液流变学特性、一些生化参数(如血浆纤维蛋白原和免疫球蛋白水平)与甲周毛细血管镜检查结果之间的关系,并进行相关性分析。所考虑的解释变量包括:血液粘度、血浆粘度、红细胞刚性指数、血浆纤维蛋白原、红细胞沉降率、红细胞聚集大小、红细胞聚集率以及血清免疫球蛋白(IgG和IgM)。响应变量是甲襞毛细血管模式,分为正常或病理状态。与具有正常模式的患者相比,具有病理模式的患者纤维蛋白原、红细胞聚集率和IgM显著更高。统计分析使我们能够根据血浆纤维蛋白原建立病理模式发生概率的模型。因此,血浆纤维蛋白原每增加100mg/dl,出现病理模式的概率就会增加一倍。所以,我们可以得出结论,雷诺现象患者的高纤维蛋白原水平与通过甲周毛细血管镜检查评估的皮肤微循环受损有关。