Fujii Yuichi, Kishimoto Shinji, Higashi Yukihito
Department of Medicine and Molecular Science, Hiroshima University Graduate School of Medical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Eur Heart J Case Rep. 2020 Dec 1;4(6):1-5. doi: 10.1093/ehjcr/ytaa394. eCollection 2020 Dec.
Raynaud's syndrome is a commonly encountered disorder. The relationship between the grade of Raynaud's phenomenon and severity of vasoconstriction is unclear. Recently, various methods including colour Doppler ultrasonography have been used for assessment of vascularity of the extremities including fingers.
A 53-year-old man had a 6-year history of Raynaud's phenomenon with typical tri-coloured changes proceeding from white, blue to red and slight pain and slight paresthaesia in the fingers of both hands when his fingers were exposed to cold. He was diagnosed with primary Raynaud's syndrome. After treatment with the calcium channel blocker amlodipine (5 mg once daily), a cold challenge did not induce Raynaud's phenomenon on the fingers in the present patient. After the cold challenge, colour Doppler ultrasonography showed that vascularity was markedly decreased or was absent, whereas there was little difference in skin colour of the fingers.
In Raynaud's phenomenon, vasospasm may occur even if the symptoms are well-controlled with a calcium channel blocker. It is unlikely that clinical symptoms in patients with Raynaud's syndrome always reflect the severity of vasoconstriction in their fingers.
雷诺综合征是一种常见疾病。雷诺现象的分级与血管收缩严重程度之间的关系尚不清楚。近来，包括彩色多普勒超声检查在内的各种方法已被用于评估包括手指在内的四肢血管情况。
一名53岁男性有6年雷诺现象病史，手指暴露于寒冷环境时，双手手指出现典型的三色变化，即从白色变为蓝色再变为红色，并伴有轻微疼痛和轻微感觉异常。他被诊断为原发性雷诺综合征。在用钙通道阻滞剂氨氯地平（每日1次，每次5毫克）治疗后，该患者手指在冷刺激时未诱发雷诺现象。冷刺激后，彩色多普勒超声检查显示血管情况明显减退或消失，而手指皮肤颜色几乎没有差异。
在雷诺现象中，即使症状通过钙通道阻滞剂得到良好控制，仍可能发生血管痉挛。雷诺综合征患者的临床症状未必总能反映其手指血管收缩的严重程度。
