Study on international standard of cold provocation test for evaluating peripheral circulatory functionr in hand-transmitted vibration diseases

自1996年起，国际标准化组织开始制定冷刺激试验作为外周循环功能的国际标准。本研究的目的是阐明在严格控制室温的情况下，试验室温度对皮肤温度、触觉和热痛阈值的影响，并提出冷激发试验的新意义。冷刺激前和冷刺激后3min，三种环境下的皮肤温度差异有统计学意义。大多数受试者在室温27℃的测量结束时皮肤温度恢复到以前的水平。另一方面，在22次℃和17次℃时，分别有40%和15%的受试者在刺激后15分钟内恢复。平均热痛和振感阈值的变化受环境温度的影响较大。皮肤温度与两种阈值均呈显著负相关，但与以前的振动触觉阈值无显著相关。振感阈值恢复较热痛阈值恢复快。在3次激发试验中，皮肤温度、振动触觉和热痛阈值的反应与室温有很强的相关性。根据激发试验的类型，应考虑试验室的适宜温度。同时测量热痛阈值和皮肤温度可为评估周围神经系统提供一些有用的信息。

ISO has started to establish an international standard for a cold provocation test as a peripheral circulatory function since 1996. The aim of this study is to clarify the effects of test room temperature on skin temperature, vibrotactile and heat pain threshold under strictly controlled room temperature, and propose a new significance of the cold provocation test. Significant differences of skin temperature among three room conditions were observed before and 3 min after cold provocation. The skin temperature at the end of measurement at 27℃ of room temperature returned to the previous level in the most of the subjects. On the other hand, 40% and 15% of the subjects only recovered within 15 min after provocation in case of 22℃ and 17℃, respectively. The changes of the mean heat pain and vibrotactile threshold were strongly influenced by room temperatures. There was a significant negative relationship between skin temperature and both thresholds except the value of previous vibrotactile threshold. The recovery of vibrotactile threshold was more faster than that of heat pain threshold. The response of skin temperature, vibrotactile and heat pain thresholds in the 3 provocation test were strongly related to the room temperature. According to the types of provocation test, an adaptable temperature of the test room should be considered. The simultaneous measurement of heat pain threshold and skin temperature can provide some useful information for evaluating the periphearl nervous system.