Department of Musculoskeletal and Skin Diseases, Rheumatology Unit, University of Pisa, Italy.
Clin Exp Rheumatol. 2013 Mar-Apr;31(2 Suppl 76):109-14. Epub 2012 Oct 22.
To investigate blood flow and microvascular reactivity by laser speckle perfusion imager (Perimed, Jarfalla) in consecutive patients affected by Raynaud's phenomenon at baseline and following dynamic stimulations.
Skin blood flow in the dorsum of the hand was measured at baseline and after cold test and post-occlusive hyperemia test in 56 consecutive subjects affected by Raynaud's phenomenon (RP), 20 primary (PRP) and 36 secondary to systemic sclerosis (SSc). Twenty healthy subjects (HS) were studied as controls.
After cold test, SSc had a significant reduction of blood flow (-58%) as compared to HS (-19%) (p=0.01). Recovery time was significantly higher in SSc (58 minutes) as compared to HS (18 minutes) and PRP (19 minutes) (p=0.006 and 0.0016, respectively). Peak flow after ischaemic test was significantly reduced in SSc (+237%) as compared to PRP (+485%) (p=0.0068). Post-ischaemic hyperemic area under the curve (AUC) was blunted in SSc (79U/sec) compared to PRP (167 U/sec) (p=0.0126). Proximal distal gradient was noticed in 74% of HS, 45% of PRP and 36% of SSc (p=0.01). Homogeneous pattern of flux distribution was significantly different between HS (95%), PRP (80%), and SSc (16%) (p<0.0001). Among SSc patients, a significant difference in ischaemic challenge was shown between patients with early-SSc versus patients with definite-SSc.
Our preliminary results indicate a clearcut alteration of the dynamic of microcirculation in SSc-RP as compared to PRP and HS. Among SSc patients, early-SSc is a separate entity as compared to established disease.
使用激光散斑灌注成像仪（Perimed，Jarfalla）在基线和动态刺激后连续检测雷诺现象患者的血流和微血管反应性。
在 56 例连续的雷诺现象（RP）患者（20 例原发性雷诺现象（PRP）和 36 例系统性硬化症（SSc）继发 RP）、20 例健康对照者（HS）中，分别在基线、冷刺激后和闭塞后充血试验时，测量手背皮肤血流。
与 HS（-19%）相比，SSc 患者冷刺激后血流明显减少（-58%）（p=0.01）。SSc 患者的恢复时间（58 分钟）明显高于 HS（18 分钟）和 PRP（19 分钟）（p=0.006 和 0.0016）。缺血试验后，SSc 患者的峰值血流（+237%）明显低于 PRP（+485%）（p=0.0068）。缺血后充血的曲线下面积（AUC）在 SSc（79U/sec）中较 PRP（167U/sec）减弱（p=0.0126）。在 74%的 HS、45%的 PRP 和 36%的 SSc 中观察到近端-远端梯度（p=0.01）。在 HS（95%）、PRP（80%）和 SSc（16%）中，通量分布的均匀模式有显著差异（p<0.0001）。在 SSc 患者中，早期 SSc 与确定的 SSc 患者在缺血挑战方面有明显差异。
我们的初步结果表明，与 PRP 和 HS 相比，SSc-RP 微循环的动态变化明显。在 SSc 患者中，早期 SSc 与已建立的疾病不同，是一个单独的实体。
