Hachulla E, Devulder B
Service de Médecine Interne, Hôpital Claude Huriez, CHRU, Lille.
Therapie. 1993 Nov-Dec;48 Spec No:707-11.
Epidemiologic studies indicate that episodic vasospasm of arterioles (Raynaud's phenomenon) is a common finding in the general population. The prevalence has been estimated at approximately 10%. Raynaud's phenomenon follows a benign course in most cases and may improve or even disappear in time. Occasionally, Raynaud's phenomenon may be induced by some drugs (beta-blockers, ergot, vinblastine...) or some occupations (pneumatic hammer operators, hand-arm vibration syndrome...) or may be a sign of connective tissue disease (systemic sclerosis, systemic lupus erythematosus, Sjögren's syndrome...). Several different physiologic mechanisms may be responsible for vasospasm: hyperactivity of the sympathetic nervous system and abnormal adrenergic receptor function appear to be most important. Calcium channel blockers have been studied extensively for the treatment of primary and secondary Raynaud's phenomenon. There have been shown to be particularly effective for inhibiting vascular responses evoked by alpha 2-adrenoceptor activity. Calcium channel blockers have been mostly effective in Raynaud's phenomenon.
流行病学研究表明，小动脉的发作性血管痉挛（雷诺现象）在普通人群中很常见。据估计，其患病率约为10%。在大多数情况下，雷诺现象病程良性，可能会随着时间的推移而改善甚至消失。偶尔，雷诺现象可能由某些药物（β受体阻滞剂、麦角、长春碱等）或某些职业（气锤操作员、手臂振动综合征等）诱发，或者可能是结缔组织病（系统性硬化症、系统性红斑狼疮、干燥综合征等）的体征。几种不同的生理机制可能导致血管痉挛：交感神经系统功能亢进和肾上腺素能受体功能异常似乎最为重要。钙通道阻滞剂已被广泛研究用于治疗原发性和继发性雷诺现象。已证明它们在抑制由α2肾上腺素能受体活性引起的血管反应方面特别有效。钙通道阻滞剂在雷诺现象中大多有效。
