von Bierbrauer A, Ehlenz K, Herzog P, Cassel W, von Wichert P
Abteilung Medizinische Poliklinik, Universität Marburg.
Dtsch Med Wochenschr. 1995 Jun 23;120(25-26):902-6.
Plasma endothelin concentration was measured separately in each hand before and after unilateral whole-hand cooling in 23 patients (5 men, 18 women; mean age 35.2 [19-52] years) thought to have primary Raynaud's syndrome (Raynaud's disease). The diagnosis was confirmed, after excluding other causes, by strain-gauge plethysmography demonstrating cold-induced vasospasm in 8, disproved in 15. In the Raynaud patients (but not in the others) the plasma concentration of endothelin on the cooled side increased from 5.13 +/- 0.18 to 6.34 +/- 0.35 pg/ml (P < 0.05). On the non-cooled side there occurred a brief rise in endothelin concentration from 5.10 +/- 0.18 to 6.23 +/- 0.35 pg/ml (P < 0.05), although there had been no evidence of vasospasm. There had been no difference between the two sides in endothelin concentration before the cold provocation. The results suggest that cold provocation in primary Raynaud's syndrome causes an increase in endothelin liberation and that this plays a role in the pathogenesis of the vasospasms. Apparently not only local but also reflex mechanisms contribute to this.
在23例疑似原发性雷诺综合征（雷诺病）的患者（5名男性，18名女性；平均年龄35.2[19 - 52]岁）中，于单侧全手冷却前后分别测量每只手的血浆内皮素浓度。在排除其他病因后，通过应变片体积描记法确诊，其中8例显示冷诱导血管痉挛，15例排除。在雷诺病患者中（而非其他患者），冷却侧的血浆内皮素浓度从5.13±0.18升高至6.34±0.35 pg/ml（P<0.05）。在未冷却侧，内皮素浓度从5.10±0.18短暂升高至6.23±0.35 pg/ml（P<0.05），尽管没有血管痉挛的证据。冷激发前两侧的内皮素浓度无差异。结果表明，原发性雷诺综合征中的冷激发导致内皮素释放增加，且这在血管痉挛的发病机制中起作用。显然，不仅局部机制，而且反射机制也对此有影响。
