Ben Salem T, Tougorti M, Bziouech S, Lamloum M, Khanfir M, Ben Ghorbel I, Houman M H
Service de médecine interne, La Rabta, Tunis, Tunisie.
Service de médecine interne, La Rabta, Tunis, Tunisie.
J Med Vasc. 2018 Feb;43(1):29-35. doi: 10.1016/j.jdmv.2017.11.005. Epub 2017 Dec 20.
Raynaud's phenomenon is a reversible episodic vasospastic disorder triggered by cold or emotion. Two types of Raynaud's phenomenon were distinguished: Raynaud's disease and secondary Raynaud's phenomenon. The purpose of this study was to determine the etiologic profile of secondary Raynaud's phenomenon in an internal medicine department.
A descriptive retrospective study including patients with secondary Raynaud's phenomenon followed in a tertiary internal medicine department between 2000 and 2013.
We included 121 patients. The sex ratio M/F was 0.16. The mean age at the onset of Raynaud's phenomenon was 41.7 years. The average age of patients at the time of the etiologic diagnosis was 47.3 years. The mean delay between Raynaud's phenomenon onset and the first consultation was 41.33 months. Raynaud's phenomenon involved hands in all cases and feet in 16.10% of cases with a typical form in most cases (41.4%). Complications (digital ulcers and scars) were noted in 32.23% of cases. Nail fold capillaroscopy showed scleroderma pattern in 49.52% of patients. Antinuclear antibodies were positive in 88.49% of patients. Interstitial lung disease was reported in 54.04% of cases. Connective tissue diseases were diagnosed in 86.77% of patients. Other secondary Raynaud's phenomenon causes were vasculitis (6.61%), atherosclerosis (1.65%) and medical or professional causes (1.65%). The most frequent one cause systemic sclerosis (n=61, 98%) followed by systemic lupus erythematosus (11.57%) and primary Sjögren syndrome (6.61%).
In our study, the Raynaud's phenomenon was most frequently secondary to connective tissue diseases. This may be a selection bias because our department is a third-line unit where patients are often referred for systemic disease suspicion.
雷诺现象是一种由寒冷或情绪引发的可逆性发作性血管痉挛性疾病。雷诺现象分为两种类型：雷诺病和继发性雷诺现象。本研究的目的是确定内科部门继发性雷诺现象的病因谱。
一项描述性回顾性研究，纳入2000年至2013年在一家三级内科部门就诊的继发性雷诺现象患者。
我们纳入了121例患者。男女比例为0.16。雷诺现象发病的平均年龄为41.7岁。病因诊断时患者的平均年龄为47.3岁。雷诺现象发作与首次就诊之间的平均间隔为41.33个月。所有病例中雷诺现象均累及手部，16.10%的病例累及足部，大多数病例（41.4%）为典型形式。32.23%的病例出现并发症（指端溃疡和瘢痕）。甲襞毛细血管镜检查显示49.52%的患者有硬皮病样表现。88.49%的患者抗核抗体呈阳性。54.04%的病例报告有间质性肺病。86.77%的患者被诊断为结缔组织病。其他继发性雷诺现象的病因包括血管炎（6.61%）、动脉粥样硬化（1.65%）以及医疗或职业原因（1.65%）。最常见的病因是系统性硬化症（n = 61，98%），其次是系统性红斑狼疮（11.57%）和原发性干燥综合征（6.61%）。
在我们的研究中，雷诺现象最常见的原因是结缔组织病。这可能存在选择偏倚，因为我们科室是一个三线科室，患者常因怀疑患有系统性疾病而被转诊至此。
