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新型指温计在评估雷诺现象患者中的应用。

Application of a novel finger temperature device in the assessment of subjects with Raynaud's phenomenon.

机构信息

Department of Dermatology and Venereology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria.

Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.

出版信息

Skin Res Technol. 2021 Nov;27(6):1110-1115. doi: 10.1111/srt.13070. Epub 2021 Jun 3.

Abstract

INTRODUCTION

Finger skin thermometry is one of the most commonly used methods for evaluating the response of the digital vessels to cold stimulation. The aim of this study was to evaluate the applicability of a novel finger skin temperature device for performing cold-stimulation test (CST) in subjects with primary and secondary Raynaud's phenomenon (RP).

METHODOLOGY

A total of 155 consecutive subjects were studied. They were divided into three groups: 73 patients with primary RP (8 males, 65 females, mean age 38.5 ± 16.2), 42 patients with secondary RP (4 males, 38 females, mean age 49.6 ± 13.1, connected with lupus erythematosus and systemic scleroderma), and 40 healthy controls (5 males, 35 females, mean age 38.8 ± 16.6). Standardized CST consisting of exposure of both hands to water with a temperature of 10℃ for 5 minutes was performed. Changes in skin temperature of both wrists and 2-5 fingers were measured using a novel finger temperature device (Courage & Khazaka). Measurements were made before and 5, 10, 15, 20, 25, and 30 minutes after cold stimulation. The time of recovery for baseline temperature of all fingers below 15 minutes was considered normal.

RESULTS

The CST was normal in 6 (8.2%) of the patients with primary RP, in 7 (16.6%) of the patients with secondary RP, and in 28 (70%) of the healthy control subjects. The time of complete recovery of baseline temperature with respect to the first finger and for all 2-5 fingers in the three groups was as follows: 24.8 and 28.5 minutes (primary RP), 21.7 and 26.8 minutes (secondary RP), and 11.1 and 15.2 minutes (healthy subjects). Furthermore, the microcirculation was seriously disturbed (rewarming time >31 minutes of all 2-5 digits of both hands) in 54.1% (n = 79), 34.5% (n = 29) and 5% (n = 4) in the same study groups.

DISCUSSION

Our results suggested that skin microcirculation is more disturbed in patients with primary RP than in patients with secondary RP. In support of this unexpected finding were the results reported by Ruaro B. et al (2019). They investigated the blood perfusion (BP) by laser speckle contrast analysis (LASCA) at different skin areas of hands and found that it was significantly lower in primary RP than in secondary RP related to systemic sclerosis.

CONCLUSION

The new finger temperature device used could be considered useful for performing cold-stimulation test in patients with Raynaud's phenomenon.

摘要

简介

手指皮肤测温是评估手指血管对冷刺激反应最常用的方法之一。本研究旨在评估一种新型手指皮肤温度设备在原发性和继发性雷诺现象(RP)患者中进行冷刺激试验(CST)的适用性。

方法

共纳入 155 例连续患者。他们分为三组:73 例原发性 RP 患者(8 例男性,65 例女性,平均年龄 38.5±16.2)、42 例继发性 RP 患者(4 例男性,38 例女性,平均年龄 49.6±13.1,与红斑狼疮和系统性硬皮病有关)和 40 例健康对照组(5 例男性,35 例女性,平均年龄 38.8±16.6)。对双手进行 5 分钟 10℃水温的标准化 CST。使用新型手指温度设备(Courage & Khazaka)测量双手腕和 2-5 个手指的皮肤温度变化。在冷刺激前和冷刺激后 5、10、15、20、25 和 30 分钟进行测量。所有手指的基础温度恢复时间在 15 分钟以内被认为是正常的。

结果

6 例(8.2%)原发性 RP 患者、7 例(16.6%)继发性 RP 患者和 28 例(70%)健康对照组的 CST 正常。三组第一指和 2-5 指的基础温度完全恢复时间如下:24.8 和 28.5 分钟(原发性 RP)、21.7 和 26.8 分钟(继发性 RP)和 11.1 和 15.2 分钟(健康受试者)。此外,在同一研究组中,54.1%(n=79)、34.5%(n=29)和 5%(n=4)的所有 2-5 个手指的微循环严重受损(复温时间>31 分钟)。

讨论

我们的结果表明,原发性 RP 患者的皮肤微循环比继发性 RP 患者更紊乱。支持这一意外发现的是 Ruaro B. 等人(2019 年)的报告。他们通过激光散斑对比分析(LASCA)研究了手部不同皮肤区域的血液灌注(BP),发现原发性 RP 患者的 BP 明显低于继发性 RP 与系统性硬化症相关。

结论

新型手指温度设备可用于 RP 患者的冷刺激试验。

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