Hahn M, Klyscz T, Jünger M, Rassner G
Department of Dermatology, University Hospital, Tübingen, Germany.
Br J Dermatol. 1995 Nov;133(5):704-9. doi: 10.1111/j.1365-2133.1995.tb02742.x.
Synchronous measurement of laser Doppler flux (LDF) and capillary red blood cell velocity (CBV) was performed in adjacent areas of the same nailfold during a local cold stress test in 12 healthy controls (eight women and four men) and in 22 patients (17 women and seven men) with secondary Raynaud's phenomenon before and after treatment. Two questions were addressed: Are there any differences in the signal pattern between LDF and RBV? Is it possible to detect early on in therapy, before clinical benefit becomes obvious, whether a treatment is successful or not? Despite the fact that the resulting signal patterns recorded by these two techniques are widely compatible, certain differences could be observed. In healthy controls, decrease of values during cooling time and increase after cooling were more distinct in RBV than in LDF. Compared with control values, CBV and LDF in patients with Raynaud's phenomenon were lower. After cooling CBV took an average of 3 min to reach initial value again as compared with 40 s in healthy controls. During 4 min observation time, pretest values of LDF were not achieved again in patients, whereas it took 50 s in healthy controls. If, after a few days of vasospasmolytic therapy, test results improved or normalized, clinical symptoms subsided gradually during the next weeks. Clinical improvement was not observed in those patients in whom cutaneous blood flow remained decreased despite therapy. CBV indicated this more clearly than LDF. Duration of flow stop at the end of cooling showed a marked improvement in patients treated successfully. Discrepancies between CBV and LDF are interpreted as being due to LDF detecting other vessels in addition to the superficial, nutritional capillaries. LDF seemed to be a poor tool for evaluating the effect of treatment. Determination of CBV and flow stop duration during local cold exposure may help in early selection of the best treatment for a patient with Raynaud's phenomenon by predicting later possible clinical benefit.
在12名健康对照者（8名女性和4名男性）以及22名继发性雷诺现象患者（17名女性和7名男性）治疗前后的局部冷应激试验中，对同一甲襞相邻区域进行激光多普勒血流（LDF）和毛细血管红细胞速度（CBV）的同步测量。研究了两个问题：LDF和RBV的信号模式是否存在差异？在治疗早期，在临床益处变得明显之前，是否有可能检测出一种治疗是否成功？尽管这两种技术记录的结果信号模式广泛兼容，但仍可观察到某些差异。在健康对照者中，冷却期间数值的下降和冷却后数值的增加在RBV中比在LDF中更为明显。与对照值相比，雷诺现象患者的CBV和LDF较低。冷却后，CBV平均需要3分钟才能再次达到初始值，而健康对照者为40秒。在4分钟的观察时间内，患者未再次达到LDF的测试前值，而健康对照者需要50秒。如果在进行了几天的血管解痉治疗后测试结果改善或恢复正常，临床症状在接下来的几周内会逐渐消退。在那些尽管接受治疗但皮肤血流仍持续减少的患者中未观察到临床改善。CBV比LDF更清楚地表明了这一点。冷却结束时血流停止的持续时间在成功治疗的患者中显示出明显改善。CBV和LDF之间的差异被解释为是由于LDF除了检测浅表营养毛细血管外还检测了其他血管。LDF似乎是评估治疗效果的一个较差工具。在局部冷暴露期间测定CBV和血流停止持续时间，通过预测后期可能的临床益处，可能有助于早期为雷诺现象患者选择最佳治疗方法。
