Priollet P
Service de médecine vasculaire et d'hypertension artérielle, Hôpital Saint-Joseph, Paris.
Rev Prat. 1998 Oct 1;48(15):1659-64.
Raynaud's phenomenon is a common paroxystic vasomotor disorder. Diagnosis is easily made based on white fingers caused by cold. Aetiological evaluation must distinguish between functional disorders (primary Raynaud's phenomenon or Raynaud's disease) and secondary Raynaud's phenomenon. Initially, physical examination as well as nailfold capillary microscopy are sufficient for the diagnosis of bilateral Raynaud's phenomenon. Prescription of other investigations is guided by the results of this first evaluation. Progressive systemic sclerosis is the first hypothesis if the bilateral vasomotor disorder does not satisfy the criteria for primary Raynaud's phenomenon. Unilateral Raynaud's phenomenon is much less common and always secondary to local or regional vascular disease. Treatment of Raynaud's phenomenon must be adapted to the level of discomfort and to the cause of the vasomotor disorder. Prescription of drugs must be restricted to the most serious cases.
雷诺现象是一种常见的阵发性血管舒缩障碍。根据寒冷导致的手指变白情况很容易做出诊断。病因评估必须区分功能性障碍(原发性雷诺现象或雷诺病)和继发性雷诺现象。最初,体格检查以及甲襞毛细血管显微镜检查足以诊断双侧雷诺现象。其他检查的开具以首次评估结果为指导。如果双侧血管舒缩障碍不符合原发性雷诺现象的标准,进行性系统性硬化症是首要考虑的诊断。单侧雷诺现象要少见得多,且总是继发于局部或区域性血管疾病。雷诺现象的治疗必须根据不适程度和血管舒缩障碍的病因进行调整。药物处方必须限于最严重的病例。