The influence of the type of microcirculatory disorders on the development of trophic changes in the skin of the hands in patients with vibration disease

Abstract

Introduction. Hypoxia caused by microcirculation disorders in patients with vibration disease leads to changes in the concentration and, accordingly, fluorescence of various biologically active substances-fluorophores in the skin of the hands, which are the markers of trophic disorders. Microcirculation disorders in this category of patients are shown to have a multidirectional character. The study of the effect of the type of microcirculatory changes on the development of trophic disorders in the skin of the hands is relevant for the patients with vibration disease. The aim of the study was to evaluate the accumulation of biologically active substances based on their fluorescence in the skin of the hands in patients with vibration disease depending on the type and degree of microcirculation disorder. Materials and methods. Thirty three miners with a proven diagnosis of vibration disease and 15 conventionally healthy men of close age without complaints and never exposed to industrial vibration were examined. Microcirculation was studied using laser Doppler flowmetry, the coefficient of fluorescent contrast of biological tissue was determined applying noninvasive optical tissue fluorescence spectroscopy. Results. The multidirectional types of microcirculation disorders in the extremities in vibration disease were revealed. Regardless of the direction of microcirculatory disorders, occurred hypoxia leads to the accumulation of biologically active substances - markers of trophic skin changes, as well those involved in antioxidant protection. A reliable gain in the fluorescence of these substances was noted in both hyperemic and spastic disorders, more significant in the hyperemic type. Limitations. The study was limited to assessing the microcirculation types and fluorescent contrast of biological tissues in 33 patients with vibration disease and in 15 conventionally healthy subjects who had never worked under the conditions of exposure to industrial vibration. Conclusion. Changes in the trophism of the skin of the hands in patients with vibration disease develop as a result of chronic hypoxia, which is the main pathophysiological link of angiodistonic syndrome, regardless of the direction of microcirculatory disorders, however, the hyperemic type can be conditionally considered more unfavourable with respect to the development of trophic skin disorders.