Pistorius M A, Planchon B, de Faucal P
Department of Internal Medicine, Hotel Dieu, Nantes, France.
Int Angiol. 1994 Mar;13(1):10-4.
The purpose of this study was to analyze the reactivity to cold in a series of 541 patients with Raynaud's phenomenon and to search for possible correlations with the functional severity and the etiologic diagnosis of the acrosyndrome. Digital reactivity to cold was quantified by a plethysmographic cold test performed under standardized conditions, using mercury-strain-gauge plethysmography. The functional severity of Raynaud's phenomenon was assessed by the weekly frequency of attacks during winter. Topographic evaluation of the acrosyndrome sought to determine the possible extension of attacks to the thumb. Factorial Analysis of Correspondences indicated a high correlation between the intensity of reactivity to cold and the frequency of thumb involvement (p = 0.0001) or the weekly frequency of attacks during winter (p < 10(-4)). There was also a close dependence between reactivity to cold and the etiologic diagnosis of the acrosyndrome (p < 10(-4)). Significant correspondences were found between mild or major types of reactivity and primary Raynaud's disease, between very severe reactivity to cold and scleroderma. This study contributes to a clinical validation of the plethysmographic cold test. During Raynaud's phenomenon, it is indicative of clinical severity and can in a certain way guide the etiologic diagnosis, particularly concerning the risk of scleroderma.
本研究的目的是分析541例雷诺现象患者对寒冷的反应性，并寻找其与肢端综合征功能严重程度及病因诊断之间可能存在的相关性。采用汞应变仪体积描记法，在标准化条件下通过体积描记法冷试验对指端对寒冷的反应性进行量化。通过冬季发作的每周频率评估雷诺现象的功能严重程度。对肢端综合征进行地形学评估，以确定发作可能扩展至拇指的情况。对应分析表明，对寒冷的反应强度与拇指受累频率（p = 0.0001）或冬季发作的每周频率（p < 10⁻⁴）之间存在高度相关性。对寒冷的反应性与肢端综合征的病因诊断之间也存在密切相关性（p < 10⁻⁴）。在轻度或重度反应类型与原发性雷诺病之间、对寒冷的极重度反应与硬皮病之间发现了显著的对应关系。本研究有助于对体积描记法冷试验进行临床验证。在雷诺现象期间，它可指示临床严重程度，并能在一定程度上指导病因诊断，尤其是关于硬皮病的风险。
