Wilkinson D, Vowden P, Gilks L, Latif A B, Rajah S M, Kester R C
Department of Vascular Surgery, St. James's University Hospital, Leeds, UK.
Br J Surg. 1989 Apr;76(4):401-5. doi: 10.1002/bjs.1800760430.
As abnormal eicosanoid (prostaglandin) metabolism has been suggested as a factor in the aetiology of vasospastic diseases we have measured levels of stable eicosanoid metabolites using a radioimmunoassay in 30 normal subjects and 31 patients with Raynaud's phenomenon. There were 13 patients with primary Raynaud's, ten with Raynaud's secondary to scleroderma and eight men with vibration white finger (VWF) disease. We have also measured platelet aggregation to adenosine diphosphate (ADP), collagen and adrenaline in 19 normal subjects, 22 patients with primary Raynaud's, 12 with Raynaud's secondary to scleroderma and 14 men with VWF. When compared with our normal subjects, patients with VWF have an elevated thromboxane B2 level, with a normal 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) level. Their platelets are less sensitive to ADP and collagen. Patients with primary and secondary Raynaud's have elevated thromboxane B2 levels but this is much more marked in the secondary group. Patients with primary Raynaud's have a normal 6-keto-PGF1 alpha level but in patients with secondary Raynaud's the 6-keto-PGF1 alpha level is markedly raised. The platelets from both groups are more sensitive to ADP and collagen and this is more marked in the secondary group. Whether these phenomena are a cause or an effect of vasospasm remains unknown.
由于异常类花生酸（前列腺素）代谢被认为是血管痉挛性疾病病因中的一个因素，我们使用放射免疫分析法测量了30名正常受试者和31名雷诺现象患者中稳定类花生酸代谢物的水平。其中有13名原发性雷诺病患者，10名硬皮病继发雷诺病患者，以及8名患有振动性白指（VWF）病的男性。我们还测量了19名正常受试者、22名原发性雷诺病患者、12名硬皮病继发雷诺病患者和14名患有VWF的男性对二磷酸腺苷（ADP）、胶原和肾上腺素的血小板聚集情况。与正常受试者相比，VWF患者的血栓素B2水平升高，而6-酮-前列腺素F1α（6-酮-PGF1α）水平正常。他们的血小板对ADP和胶原的敏感性较低。原发性和继发性雷诺病患者的血栓素B2水平均升高，但在继发性组中更为明显。原发性雷诺病患者的6-酮-PGF1α水平正常，但继发性雷诺病患者的6-酮-PGF1α水平明显升高。两组患者的血小板对ADP和胶原更敏感，且在继发性组中更为明显。这些现象是血管痉挛的原因还是结果仍不清楚。
