02-4 Aberrant temperature disparity in fingers, and its amelioration by warming therapies, in connective tissue diseases patients / 日本温泉気候物理医学会雑誌

ABSTRACT

Introduction: Human body has systems that preserve its homeostasis, corresponding to a spectrum of stimuli. As for thermal stimuli, vasculatures would react most, and changes in blood flow could be observed as skin temperature measured by thermography. In case that vasculature gets sickened, its response may change. We have observed that temperature unevenness/disparity among fingers is the most useful finding to see disturbed peripheral circulation in connective tissue diseases (CTDs) patients, although low temperatures prior to immersion and their delayed recovery after immersion are distinguished. Objectives: To examine whether warm stimulus ameliorates temperature disparity, and if it works, whether any differences are between warm tap water and warm water containing CO2. Patients and methods: CTD patients with signs or symptoms of circulatory disturbance in periphery of extremities were tested for thermo-loading test. Loading was hands immersion in 42C tap water or water containing CO2 (1000 ppm) for 10’’. Coefficient of variation (CV, mean of right & left SD/mean of 5 nailfolds’ temperature) was calculated at each measuring point (baseline, 0, 3, 5, 10, 15, 20, 30 minutes after the immersion), its change from baseline was examined, and the CV change was compared between tap and CO2 warm water. Results: Twenty-one (F20, M1, 60.0±17.1 year-old) , and 24 (F22, M2 58.3±19.4 y) patients were tested for tap and CO2 water immersion, respectively. Before warm bathing, varying levels of CV was observed from patient to patient (tap, 0.020+/-0.014; CO2 0.029+/-0.029, p<0.05). Just after the immersion, CV decreased in all of the patients (0.010+/-0.003, p<0.05 vs. baseline; 0.013+/-0.005, p<0.05). Then, afterward, CV gradually re-increased toward the level at baseline prior to bathing; however, until 20’ after, CV was still lower than that at baseline, in both immersions (data not shown). Thirty minutes after the immersion, CV re-increased to a level not statistically different from that at baseline in tap water immersion (0.018+/-0.011, ns); however, CV was still statistically lower in CO2 water immersion (0.016+/-0.014, p<0.05). Conclusion: Hands immersion in warm tap water and warm CO2 water both once ameliorated varied temperature, evaluated by CV. Amelioration was dissolved 30’ after the immersion in tap water, but sustained even 30’ after the immersion in CO2 water, in spite of higher CV in CO2 group