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Journal of the Korean Academy of Family Medicine 2003;24(12):1085-1091.
Published online December 10, 2003.
The Prevelance of Diagnosis as Raynaud's Disease among the People Complaint of Abnormal Sensation on Hands and Feet.
Whan Seok Choi, Seon Myoung Ock, Jun Hee Byeon, Sang Hoon Jung, Kyung Su Park, Jeong Wook Park, Dong Jin Yoo, Jung Bok Lee, Churl Min Kim
1Department of Family Medicine, College of Medicine, The Catholic University of Korea, Korea. musofm@unitel.co.kr
2Department of Plastic Surgery, College of Medicine, The Catholic University of Korea, Korea.
3Department of Rhematology, College of Medicine, The Catholic University of Korea,Korea.
4Department of Neurology, College of Medicine, The Catholic University of Korea, Korea.
5Bayer Korea, Korea.
6Stastical Institute the Korea University, Korea.
수족부 감각이상자에서 레이노병의 유병률
최환석,옥선명,변준희,정상훈,박경수,박정욱,유동진,이정복,김철민
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Abstract
Background
: The previous studies suggested that the rate of the people who reported having sensitivity to cold and Raynaud's disease were 12% and 5∼10% of general population respectively. There are surprisingly few data on 'cold hands and feet syndrome', the conventional circulatory disorder in far-eastern Asia in spite of the assumption that it is a common disorder among Korean population. Besides, the prevalence of Raynaud's disease has not been studied for Korean complaint of the syndrome. Therefore, we conducted the survey regarding the frequency of Baynaud's disease and phenomenon among the people appealed abnormal sensory symptoms on hands and feet, and 'cold hands and feet syndrome'.

Methods : The questionnaires were asked to 1,008 out- patients who complained abnormal sensory symptoms on hands and feet. The subjects were screened among the patients who visited the clinics, mainly department of family medicine in Uijongbu St. Mary's hospital from January to July 2003.

Results : The most common abnormal sensory symptoms were tingling feeling and coldness, pain in the descending order. The mean age of the patients is 47 years, the average age at the onset of the symptoms is 40 years, and the mean duration they had been suffered by the symptoms is 7 years. During interview, 289 patients voluntarily appealed 'cold hands and feet syndrome' in expression of "I have cold extremities" or "I have the syndrome". Among the screened patients, 510 patients answered, "yes" to the question "Are your fingers unusually sensitive to cold?" Two hundred and nineteen patients (43%) of them showed Raynaud's phenomenon. One hundred and sixty patients were diagnosed as Raynaud's disease among 219 patients who had Raynaud's phenomenon. The rest 59 patients were diagnosed as secondary Raynaud's phenomenon. Eighty-seven patients (30%) of 289 patients who voluntarily reported 'cold hands and feet syndrome' were diagnosed as Raynaud's disease. The average age of Raynaud's disease patients is 37 years old, average first attack age is 24 years, and average suffering period is 14 years. Only 10% of cases experienced the first attacks after 40 years old. The attack rates are different by gender. The ratio is 2.3 and higher in female. Only six patients (4%) of Raynaud's disease had been diagnosed accurately. Fifty-three patients (33%) have family history and 41 of them are the first-degree relatives. The causes of secondary Raynaud's phenomenon (59 patients) are connective tissue disorders, neurologic diseases, carpal tunnel syndrome, hypothyroidism, vascular disorders, etc. The statistically significant factors that influence on Raynaud's disease are female, below 40 years old, stress, family history, hypertension, diabetes, etc. The statistical analysis in this study does not prove the association between the disease and the factors such as physical labor, manual labor using hands heavily, smoking, drinking, thyroid diseases, joint disorders, ischemic heart disease, depression.

Conclusion : Raynaud's disease has been underlooked even though it is not uncommon and can be easily diagnosed and treated. In conclusion, the result of our study suggests that abnormal sensory symptoms on hands and feet, especially 'cold hands and feet syndrome', the conventional circulatory disorder, are the medical condition where special concern on Raynaud's disease is required.
Key Words: Raynaud's disease, abnormal sensations on hands and feet, cold hand
초록
연구

방법 : 수족 냉증의 유병률은 12%에 이르고, 레이노병은 인구의 5∼10%라고 한다. 우리나라에서 수족냉증이 적지 않을 것이란 추측은 많았지만 실제적인 조사는 없었고, 수족부 감각이상자에서 레이노병에 대한 유병률 조사도 없었다. 이에 저자들은 수족부 감각이상과 수족냉증, 레이노병의 유병률과 상관관계를 조사하였다.

방법 : 2003년 1월부터 7월까지 의정부성모병원 가정의학과 등을 방문한 외래환자 중 수족부 감각이상을 호소한 986명을 대상으로 수족부 감각이상과 레이노병에 대한 설문조사를 하였다.

결과 : 수족부 감각이상자들은 저리다는 표현을 가장 많이 했고, 다음으로 냉증이나 통증을 호소하였다. 감각이상은 손에 많이 나타났다. 감각이상자의 평균연령은 47세, 초발은 40세, 유병기간은 7년이었다. 선별 질문을 통해 추위에 민감하다고 수동적 수족냉증을 호소한 사람은 510명(52%)이었으며, '차다', 혹은 냉증이란 표현 등으로 능동적으로 수족냉증을 호소한 사람은 289명(26%)이었다. 수동적 수족냉증을 호소한 510명 중 219명(43%)이 레이노 현상을 보였고, 이 중 160명은 레이노병으로 진단되었다. 나머지 59명은 이차성 레이노 현상으로 진단되었다. 능동적 수족냉증을 호소한 289명 중 87명(30%)은 레이노병으로 진단되었다. 레이노병 환자의 평균연령은 37세, 평균 초발 연령은 24세, 평균 유병기간은 14년이었다. 40세 이후에 발병한 경우는 10%에 불과했다. 성비는 2.3으로 여성에서 많았다. 한 손에만 이환된 경우는 18%였다. 레이노병 환자 중 6명(4%)만이 이전에 정확히 진단 받았다고 하였다. 53명(33%)이 가족력이 있었고, 이 중 41명(77%)은 일차가족이었다. 59명의 이차성 레이노 현상의 원인은 결합조직질환, 신경질환, 수근관 증후군, 갑상선기능저하, 혈관질환 등이었다. 이차성의 경우, 한손에만 이환된 경우는 6명(14%)이었다. 카이제곱 검정에서 통계적으로 유의하게 레이노병의 분포에 영향을 주는 인자로는 여성, 40세 미만, 스트레스, 가족력, 고혈압, 당뇨 등이 있었다(P<0.05). 노동, 수작업, 흡연, 음주, 갑상선질환, 관절염, 허혈성 심질환, 우울증 등은 유의한 영향을 주지 않았다.

결론 : 수족부감각이상자의 16%, 추위 민감자의 31%, 능동적 수족냉증 호소자의 30%가 레이노병으로 진단되었다. 레이노병은 진단과 치료가 용이하면서, 드물지 않은 문제임에도 불구하고 간과되고 있다. 수족부 감각이상 특히, 수족냉증 호소자에서 레이노병에 대한 각별한 관심이 요구된다.
중심 단어: 레이노병, 수족부 감각이상, 수족냉증
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