Hatron P Y, Frimat P, Hachulla E
Service de médecine interne A, Hôpital Claude-Huriez, CHRU, Lille.
Rev Prat. 1998 Oct 1;48(15):1653-8.
Raynaud's phenomenon must systematically lead to the research of a professional cause, mainly if the patient is a manual worker. The most frequent professional cause is vibrations disease which involves different occupations, especially woodcutters. In this disease, Raynaud's phenomenon may be associated with neurological or rheumatic manifestations. Prevention relies on tool improvement and reduction of exposure-time. The more uncommon hammer's syndrome is characterized by the onset of a terminal cubital artery aneurysm, resulting from repeated trauma on the palm of the hand. Raynaud's phenomenon is severe, with frequent trophic complications related to embolic migration towards digital arteries. Improved prevention explains that acrosyndromes related to vinyl chloride exposure are now very rare. Finally, a Raynaud's phenomenon may be the first symptom of a systemic sclerosis induced by silicate exposure.
雷诺现象必须系统地进行职业病因的排查,尤其是当患者为体力劳动者时。最常见的职业病因是振动病,涉及不同职业,尤其是伐木工人。在这种疾病中,雷诺现象可能与神经或风湿性表现相关。预防措施包括改进工具和减少暴露时间。较为罕见的锤击综合征的特征是终末肘动脉动脉瘤的形成,这是由于手掌反复受到创伤所致。雷诺现象较为严重,常伴有与栓子向指动脉迁移相关的营养并发症。预防措施的改进使得与氯乙烯暴露相关的肢端综合征现在非常罕见。最后,雷诺现象可能是硅酸盐暴露引起的系统性硬化症的首发症状。