Ziegler Sophie, Gschwandtner Michael, Zöch Carina, Barth Alfred, Minar Erich, Rüdiger Hugo, Osterode Wolf
Division of Angiology, Clinic for Internal Medicine II, University of Vienna of the Vienna General Hospital, Währinger Gürtel, Vienna, Austria.
Microvasc Res. 2004 Nov;68(3):203-8. doi: 10.1016/j.mvr.2004.06.006.
We evaluated two microcirculatory function-tests, the Laser Doppler (LD)-Anemometry and the Laser Doppler Imager (LDI)-Flowmetry in their value to further elucidate functional behavior of the "Vibration-induced white finger syndrome" (VWF) and to distinguish between Raynaud's phenomenon (RP) of idiopathic or vibration origin.
Ninety-four patients, suffering from RP were studied (78 patients with primary RP and 16 patients with VWF). Measurement of blood cell velocity (BCV) before and after provocation was obtained by nailfold capillary microscopy and an included Laser detector ("Anemometry"). Digital blood flux was recorded by LDI-Flowmetry during a standardized cooling and rewarming thermal challenge.
"Time to peak" of BCV, a measure of maximal reactive hyperemia was longer in VWF in comparison to primary RP (30.37 versus 19.29 sec P < 0.02), respectively.
Based on the fact, that prolongation of reactive hyperemia, an indicator of impaired endothelium-dependent vasodilation is also frequently found in peripheral arterial occlusive disease, it is hypothesized that VWF is not only a microcirculatory vasospastic disorder, but may also be related to atherosclerosis. Anemometry, in association with an appropriate provocation-test, could represent a useful non-invasive method for objectifying diagnosis of VWF in patients with RP.
我们评估了两种微循环功能测试,即激光多普勒血流仪(LD)和激光多普勒成像仪(LDI)血流测量法,以进一步阐明“振动性白指综合征”(VWF)的功能行为,并区分特发性或由振动引起的雷诺现象(RP)。
研究了94例患有RP的患者(78例原发性RP患者和16例VWF患者)。通过甲襞毛细血管显微镜和内置激光探测器(“血流仪”)测量激发前后的血细胞速度(BCV)。在标准化的冷却和复温热刺激过程中,通过LDI血流测量法记录数字血流量。
与原发性RP相比,VWF中作为最大反应性充血指标的BCV“达到峰值的时间”更长(分别为30.37秒对19.29秒,P<0.02)。
基于这样一个事实,即反应性充血延长(内皮依赖性血管舒张受损的一个指标)在周围动脉闭塞性疾病中也经常出现,因此推测VWF不仅是一种微循环血管痉挛性疾病,还可能与动脉粥样硬化有关。血流仪与适当的激发试验相结合,可能是一种用于客观诊断RP患者VWF的有用非侵入性方法。