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雷诺现象是否存在交感皮肤反应异常?

Is there any Sympathetic Skin Response Abnormality in Raynaud Phenomenon?

机构信息

Bone and Joint Diseases Research Center, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.

Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Sultan Qaboos Univ Med J. 2022 May;22(2):274-279. doi: 10.18295/squmj.4.2021.066. Epub 2022 May 26.

Abstract

OBJECTIVES

This study aimed to evaluate sympathetic skin response (SSR) among patients with Raynaud phenomenon (RP). SSR is a technique for assessment of the damage of peripheral neuropathies and the disorders of the sympathetic system.

METHODS

Between January 2015 and December 2018, approximately 20 patients with RP and 20 healthy subjects (control group) were recruited from patients referred to the outpatient clinics of Shiraz University of Medical Sciences, Shiraz, Iran. All participants were clinically examined and the SSR was evaluated using a standard protocol. SSR is abnormal when the latency is prolonged and/or the amplitude is reduced.

RESULTS

The RP group consisted of 19 women (95%) and one male (5%); three patients (15%) had primary Raynaud's phenomenon (PRP) and 17 patients (85%) had secondary Raynaud's phenomenon. The control group consisted of 16 women (80%) and four males (20%). The mean age of the RP group and control subjects was 43.1 ± 9 and 36.7 ± 8.6 years, respectively. The SSR to the electrical stimulus was absent in three patients with PRP. The total median nerve mean latencies in the upper limb were 1.90 ± 0.57 and 1.19 ± 0.52 seconds for the RP group and control groups, respectively ( <0.001). These findings revealed significantly prolonged SSR latencies in the RP group, while the mean amplitude showed no significant differences in both groups ( = 0.756).

CONCLUSION

Absence or prolonged latency of SSR was associated with the disorders of the unmyelinated axons in the sympathetic system. The findings of the present study suggested the disorders of unmyelinated axons in Raynaud's phenomenon.

摘要

目的

本研究旨在评估雷诺现象(RP)患者的交感皮肤反应(SSR)。SSR 是一种评估周围神经病变和交感神经系统紊乱的技术。

方法

2015 年 1 月至 2018 年 12 月,从伊朗设拉子谢里夫医科大学门诊就诊的患者中招募了大约 20 例 RP 患者和 20 名健康受试者(对照组)。所有参与者均进行了临床检查,并采用标准方案评估 SSR。潜伏期延长和/或幅度降低时 SSR 异常。

结果

RP 组由 19 名女性(95%)和 1 名男性(5%)组成;3 例(15%)为原发性雷诺现象(PRP),17 例(85%)为继发性雷诺现象。对照组由 16 名女性(80%)和 4 名男性(20%)组成。RP 组和对照组的平均年龄分别为 43.1±9 和 36.7±8.6 岁。3 例 PRP 患者的 SSR 对电刺激无反应。上肢正中神经的总平均潜伏期分别为 RP 组和对照组的 1.90±0.57 和 1.19±0.52 秒(<0.001)。这些发现表明 RP 组 SSR 潜伏期明显延长,而两组的平均幅度无显著差异(=0.756)。

结论

SSR 的缺失或潜伏期延长与交感神经系统无髓轴突的紊乱有关。本研究的结果表明,雷诺现象存在无髓轴突紊乱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b01d/9155028/11ff32c991de/squmj2205-274-279f1.jpg

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