Toibana N, Ishikawa N, Sakakibara H, Yamada S
Department of Internal Medicine, Tokushima Kensei Hospital, Japan.
Nagoya J Med Sci. 1994 May;57 Suppl:121-8.
Eleven patients with Raynaud's phenomenon of the toes as well as the fingers were encountered among about 1,000 vibration-exposed patients. They consisted composed of four chain-saw operators, five rock drillers, a stone quarrier and a welder in a shipyard. All the cases were examined carefully for differential diagnosis, but there were no particular abnormalities in hematological, immunological and homodynamic examinations. The rock drillers, quarrier and welder had direct vibration exposure of the foot, which was considered to be responsible for their Raynaud's phenomenon of the toe. Four chain-saw operators, who had been little exposed to vibration of the foot directly, were examined further on skin temperature of fingers and toes every three hours except at night and in a 30-min cold provocation test at 5 degrees C. The skin temperature of both their fingers and toes was lower than in age-matched healthy controls. The chain-saw operators started to work in the 1960's and early in the 1970's, when the chain saw vibration level was high. It is, hence, considered that they were exposed to strong vibration of the hand from chain saws, and then suffered severe Raynaud's phenomenon of both fingers and toes.
在大约1000名接触振动的患者中，发现有11名患者出现了手指和脚趾的雷诺现象。他们包括4名电锯操作员、5名凿岩工、1名采石工和1名造船厂焊工。对所有病例都进行了仔细的鉴别诊断检查，但血液学、免疫学和血液动力学检查均未发现特殊异常。凿岩工、采石工和焊工的足部直接接触振动，这被认为是他们脚趾出现雷诺现象的原因。4名几乎没有直接接触足部振动的电锯操作员，除夜间外，每3小时测量一次手指和脚趾的皮肤温度，并进行了一次30分钟的5摄氏度冷激发试验。他们手指和脚趾的皮肤温度均低于年龄匹配的健康对照组。这些电锯操作员于20世纪60年代和70年代初开始工作，当时电锯的振动水平很高。因此，认为他们手部受到电锯强烈振动，进而出现了严重的手指和脚趾雷诺现象。
