Herrick A L, Rieley F, Schofield D, Hollis S, Braganza J M, Jayson M I
University of Manchester Rheumatic Diseases Centre, Hope Hospital, Salford, UK.
J Rheumatol. 1994 Aug;21(8):1477-83.
To investigate the possibility that micronutrient antioxidant status is an important factor in determining the severity of Raynaud's phenomenon (RP) and in differentiating between patients with primary Raynaud's phenomenon (PRP) and those in whom Raynaud's is secondary to systemic sclerosis (SSc).
Four micronutrient antioxidants (selenium, vitamin E, beta-carotene and ascorbic acid) and 2 "markers" of free radical associated activity were assayed in peripheral blood from 10 patients with PRP, 9 with limited cutaneous SSc (ISSc), 9 with diffuse SSc (dSSc) and 15 healthy control subjects.
Plasma ascorbic acid was reduced in all 3 groups of patients: median level 10.6 mg/l in controls, 4.8 mg/l in PRP (p < 0.01), 2.5 mg/l in ISSc (p < 0.01) and 6.8 mg/l in dSSc (p < 0.05). A reduction in serum selenium was especially found in dSSc (median 75 micrograms/l compared to 100 micrograms/l in controls, p < 0.05). In keeping with these deficiencies, the serum concentration of 9, 11, linoleic acid was elevated in RP patients: median values for the molar ratio of the isomer to the parent fatty acid were 1.91% in controls, 3.70% in ISSc (p < 0.05) and 3.85% in dSSc (p < 0.01). Smoking patients showed lower levels of ascorbic acid and higher levels of the linoleic isomer than nonsmokers.
Deficiencies of ascorbic acid and selenium may predispose towards irreversible tissue injury in RP patients and cigarette smoke may be an independent risk factor. Micronutrient antioxidant supplements may be of therapeutic value.
探讨微量营养素抗氧化状态是否是决定雷诺现象（RP）严重程度以及区分原发性雷诺现象（PRP）患者和继发于系统性硬化症（SSc）的雷诺现象患者的重要因素。
对10例PRP患者、9例局限性皮肤型SSc（lSSc）患者、9例弥漫性皮肤型SSc（dSSc）患者和15名健康对照者的外周血进行了4种微量营养素抗氧化剂（硒、维生素E、β-胡萝卜素和抗坏血酸）以及2种自由基相关活性“标志物”的检测。
所有3组患者的血浆抗坏血酸均降低：对照组中位数水平为10.6mg/L，PRP组为4.8mg/L（p<0.01），lSSc组为2.5mg/L（p<0.01），dSSc组为6.8mg/L（p<0.05）。尤其在dSSc组发现血清硒降低（中位数75μg/L，对照组为100μg/L，p<0.05）。与这些缺乏情况一致，RP患者血清9,11-亚油酸浓度升高：异构体与母体脂肪酸摩尔比的中位数在对照组为1.91%，lSSc组为3.70%（p<0.05），dSSc组为3.85%（p<0.01）。吸烟患者的抗坏血酸水平较低，亚油酸异构体水平高于非吸烟者。
抗坏血酸和硒缺乏可能使RP患者易发生不可逆组织损伤，吸烟可能是一个独立危险因素。微量营养素抗氧化剂补充剂可能具有治疗价值。
