振动性白指患者和接振工人振动负荷和冷水试验前后红外线摄像研究

THERMOGRAPHYC FINDING OF PERIPHERAL CIRCULATION BY VIBRATON LOADING AND COLD PROVACATTON IN THE PATIENTS WITH VIBRATION SYNDROME

本文报道了应用红外线摄像和电子计算机枝术,对振动性白指患者27名、其中重症患者13名,及年龄、工龄相似的接振健康工人13名,在施加手臂振动和冷水负荷试验前后和不同室温(25℃及15℃)条件下,进行手部红外线摄像动态观察,研究其皮肤变化规律;并在负荷前后测定了重症患者的血清去甲肾上腺素浓度。结果表明,振动负荷前后的患者手指皮温显著降低,皮温变化曲线改变,重症患者尤著;指温分布图像显示尺神经支配的范围似有更明显的变化。冷水负荷后皮温降低,恢复延迟,在10分钟时差异具有显著性。复温时间比皮温绝对值更有意义。患者在室温较低(15℃)时,负荷前后指温处于更低水平,并多有全身和手部不适主诉,提示在振动和低温负荷下,患者外周循环障碍能更明显地表现出来。重症患者血清去甲肾上腺素浓度显著升高,显示交感神经机能亢进。认为神经-体液因素在振动性白指发生、发展中的作用,值得进一步研究。利用红外线摄像结合负荷试验,通过体表温度异常反应、研究振动性白指的病理生理变化和诊断方法,提供了一个有价值的途径。

In this study,the subjects consists of 21 patients with VWF incl-uding 13 severe cases and 13 workers exposured to vibration but without VWF,Their age and duration of exposure were similar in this two groups bya matchedpair method.The finger skin temperature was measured on all fingers by a thermography (NIHON DENSHI JTG-3300)before and after vibration loading test(the acceleration levels:130-140 1B,2.min.)and water cold provacation(10℃10min.) in different room temperature(25℃ and 15℃).The serum concentrationof noradrenalin in the patients with severe VWF was measured during the vibr-ation-cold loading.The results showed that the finger temperature of patientswits VWF was lower than workers without VWF before and after loading test,particularly in the severe cases and in the low room temperature.The distribn-tionsof temperature patterns and the rewarming time of skin temperature wasalso different significantly between these groups.The serum concentration ofnoradrenaIin in the severe VWF after loading was higher than other cases.It ina valuable method to use the thermography with loading tests for studing thephysiopathological changes and diagnostic indications in the patients with VWF.