Kuriyama N
Department of Public Health, School of Medicine, Kanazawa University.
Nihon Eiseigaku Zasshi. 1990 Dec;45(5):990-9. doi: 10.1265/jjh.45.990.
Using an improved system for measuring skin blood flow by the thermal clearance curve, the change of the skin blood flow in the finger (finger blood flow) of the workers using vibratory tools induced by 10 degrees C cold water immersion for 10 min was observed in order to clarify the pathogenesis of vibration-induced white finger (VWF) from the aspect of peripheral circulatory function and simultaneously to demonstrate the efficiency of the system. The subjects constituted a group of 10 workers with VWF (VWF group) and 10 healthy workers without a history of hand-arm symptoms (control group). Ages and years of exposure to vibration in the two group were almost equal. The results were as follows. 1) While the finger blood flow in the control group was remarkably decreased at 1 min after the immersion, the decrease in the VWF group was low as compared with that in the control group. This result shows that vasoconstriction just after the immersion in VWF patients is not as great as that in the control group. 2) The finger blood flow in the control group at 5 min after the immersion was increased. In contrast no increase in the VWF group was observed. These results showed that cold-induced vasodilatation (CIVD) in VWF patients diminished. 3) An increase of the finger blood flow at 1 min after stopping the immersion was observed in the VWF group. These results suggest that the property of reaction to cold in VWF patients is not excessive vasoconstriction as has been hypothesized, but the diminution of CIVD. Apart from 10 workers of VWF group, observing the change of the finger blood flow in a case in which VWF was provoked by the immersion, the author found an abnormal decrease of the finger blood flow at 5 min after the immersion. This finding supports the hypothesis that the diminution of CIVD plays an important role in VWF attack as well. Concerning the characteristics of peripheral circulatory function in VWF patients, it can therefore be considered that its reaction in VWF attack is vasospasms, while the reaction to cold is the diminution of CIVD in the non-attack phase. The cold water immersion test using the system was recognized to be useful for diagnostic examination because the estimation of finger blood flows at both measuring points, 1 min and 5 min after the immersion, could fairly well discriminate VWF patients from healthy workers.(ABSTRACT TRUNCATED AT 400 WORDS)
采用一种改进的通过热清除曲线测量皮肤血流的系统，观察了使用振动工具的工人手指（手指血流量）在10℃冷水浸泡10分钟后皮肤血流量的变化，以便从外周循环功能方面阐明振动性白指（VWF）的发病机制，并同时证明该系统的有效性。受试者包括10名患有VWF的工人（VWF组）和10名无手臂症状病史的健康工人（对照组）。两组的年龄和振动暴露年限几乎相等。结果如下：1）对照组在浸泡后1分钟时手指血流量显著下降，而VWF组的下降幅度低于对照组。这一结果表明，VWF患者浸泡后即刻的血管收缩程度不如对照组。2）对照组在浸泡后5分钟时手指血流量增加。相比之下，VWF组未观察到增加。这些结果表明，VWF患者的冷诱导血管舒张（CIVD）减弱。3）VWF组在浸泡停止后1分钟时手指血流量增加。这些结果表明，VWF患者对寒冷的反应特性并非如所假设的过度血管收缩，而是CIVD减弱。除了VWF组的10名工人外，作者在观察了一例因浸泡诱发VWF的病例中手指血流量的变化，发现在浸泡后5分钟时手指血流量异常下降。这一发现支持了CIVD减弱在VWF发作中也起重要作用的假设。因此，关于VWF患者外周循环功能的特征，可以认为其在VWF发作时的反应是血管痉挛，而在非发作期对寒冷的反应是CIVD减弱。使用该系统的冷水浸泡试验被认为对诊断检查有用，因为在浸泡后1分钟和5分钟这两个测量点对手指血流量的评估能够较好地区分VWF患者和健康工人。
