Klein C, Brown R, Wenning G, Quinn N
University Department of Clinical Neurology, Institute of Neurology, London, England.
Mov Disord. 1997 Jul;12(4):514-8. doi: 10.1002/mds.870120407.
Patients with multiple system atrophy (MSA) often have cold, dusky, violaceous hands, with poor circulatory return after blanching by pressure. We therefore compared hand skin temperature in nine age-matched subjects with probable MSA, 10 with idiopathic Parkinson's disease (PD), and 10 healthy controls both at rest and following a standard cooling procedure. Baseline skin temperature in the MSA group was significantly lower than in both the PD and control groups, and four of the nine MSA patients were colder at baseline than the coldest control value. After cooling, the MSA group also showed a significantly greater reduction in skin temperature than the PD group. The rate of skin temperature recovery did not differ between the three groups, although the MSA group required more time to return completely to their baseline temperature. Changes in skin colour or temperature are easily detected, and suggest a defect in neurovascular control of distal extremities. The "cold hands sign" is another clinical "red flag" that helps to raise the suspicion of MSA.
多系统萎缩（MSA）患者的双手常常冰凉、发暗、呈紫红色，按压后变白，血液循环恢复较差。因此，我们比较了9名年龄匹配的疑似MSA患者、10名特发性帕金森病（PD）患者和10名健康对照者在静息状态下以及经过标准冷却程序后的手部皮肤温度。MSA组的基线皮肤温度显著低于PD组和对照组，9名MSA患者中有4名在基线时的体温比最冷的对照值还要低。冷却后，MSA组的皮肤温度下降也显著大于PD组。三组之间皮肤温度恢复率没有差异，尽管MSA组需要更多时间才能完全恢复到基线温度。皮肤颜色或温度的变化很容易检测到，这表明远端肢体的神经血管控制存在缺陷。“冷手征”是另一个临床“警示信号”，有助于提高对MSA的怀疑。
